Cancer Causes & Control

, Volume 27, Issue 4, pp 553–560

Age at cancer diagnosis, amenability to medical interventions, and racial/ethnic disparities in cancer mortality

  • Parisa Tehranifar
  • Abhishek Goyal
  • Jo C. Phelan
  • Bruce G. Link
  • Yuyan Liao
  • Xiaozhou Fan
  • Manisha Desai
  • Mary Beth Terry
Original paper

DOI: 10.1007/s10552-016-0729-2

Cite this article as:
Tehranifar, P., Goyal, A., Phelan, J.C. et al. Cancer Causes Control (2016) 27: 553. doi:10.1007/s10552-016-0729-2

Abstract

Purpose

Racial disparities in cancer mortality may be greater for cancers that are amenable to available early detection and treatment (amenability level). We investigated whether these patterns vary by age at cancer diagnosis.

Methods

Using 5-year relative survival rates (5Y-RSR), we classified 51 cancer sites into least amenable, partly amenable, and mostly amenable cancers (<40 %, 40–69 %, ≥70 % 5-YRS, respectively). We examined whether racial disparities in mortality rates (African-Americans, Asian/Pacific Islanders, Hispanics, whites), as estimated through Cox regression models, were modified by age at diagnosis and amenability level in 516,939 cancer cases diagnosed in 1995–1999.

Results

As compared with whites, all racial minority groups experienced higher cancer mortality rates in the youngest age group of 20–34 years. African-Americans and Hispanics diagnosed with partly and mostly amenable cancers had higher mortality rates relative to whites with cancers of the same amenability levels; further, these differences decreased in magnitude or reversed in direction with increasing age. In contrast, the racial differences in mortality were smaller and remained fairly constant across age groups for least amenable cancers. For example, in the youngest (20–34) and oldest (80–99) age groups, the adjusted hazard ratios (HRs) for African-Americans versus whites with least amenable cancers were, respectively, 1.26 (95 % CI 1.02, 1.55) and 0.90 (95 % CI 0.85, 0.96), while the HRs for African-Americans versus whites with mostly amenable cancers were 2.77 (95 % CI 2.38, 3.22) and 1.07 (95 % CI 0.98, 1.17).

Conclusions

Cancer survival disadvantage for racial minorities is larger in younger age groups for cancers that are more amenable to medical interventions.

Keywords

Age Racial/ethnic disparities Cancer mortality Medical advances Survival factors 

Supplementary material

10552_2016_729_MOESM1_ESM.pptx (187 kb)
Supplementary material 1 (PPTX 187 kb)

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Parisa Tehranifar
    • 1
    • 2
  • Abhishek Goyal
    • 1
  • Jo C. Phelan
    • 3
  • Bruce G. Link
    • 1
    • 3
    • 4
  • Yuyan Liao
    • 1
  • Xiaozhou Fan
    • 1
  • Manisha Desai
    • 5
  • Mary Beth Terry
    • 1
    • 2
    • 6
  1. 1.Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkUSA
  2. 2.Herbert Irving Comprehensive Cancer CenterColumbia University Medical CenterNew YorkUSA
  3. 3.Department of Sociomedical SciencesColumbia University Mailman School of Public HealthNew YorkUSA
  4. 4.Department of Public PolicyUniversity of California RiversideRiversideUSA
  5. 5.Department of Medicine, Division of General Medical DisciplinesStanford UniversityPalo AltoUSA
  6. 6.The Imprints Center for Genetic and Environmental Lifecourse StudiesColumbia UniversityMailman School of Public HealthNew YorkUSA