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Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population

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Abstract

Background

Racial difference in cancer-related mortality has been described in epidemiological studies and evidence points towards higher mortalities in the minorities. To determine the magnitude of racial disparities and sex differences in GI cancer-related mortalities in the US population, we analyzed the data using the third National Health and Nutrition Examination Survey (NHANES III) and related mortality data files.

Methods

NHANES III and its related public linked mortality files were used for this study. Our study cohort included subjects who were ≥18 years and were part of the longitudinal mortality follow-up database. The overall GI cancers related mortality was calculated using combined mortality from malignant neoplasm of esophagus, stomach, colon, liver and pancreas. The evaluation of independent predictors of overall GI cancer-related mortality and of each individual GI cancer was carried out using the Cox proportional hazards model.

Results

A total of 13,221 individuals were included in the analyses with the average person year follow-up of 13.9 years. During the follow-up period, 4,146 subjects died. Of these, 199 were from GI-related cancers. Non-Hispanic black (NHB) had significantly higher overall GI-cancer related mortality compared to non-Hispanic white (NHW, adjusted hazard ratio, aHR: 2.31, 95 % CI 1.57–3.38, p < 0.001). Subgroup analyses by sex demonstrated higher mortality from gastric, colorectal and primary liver cancer related mortality in NHB men compared to NHW men. Esophageal and pancreatic cancer mortalities were higher in NHB women compared to NHW women.

Conclusion

Overall GI cancer-related mortality is significantly higher among NHB compared to NHW in the US population.

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Acknowledgments

This study is supported by K08 AA016570 from the NIH/NIAAA, 1I01CX000361-01 from the Veterans Affairs Research and Administration, and Central Society for Clinical Research Career development award, and Research Support Fund Grant (S.L).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Internal Medicine, Detroit Medical Center, Wayne State University, Detroit, MI, USA

    Raxitkumar Jinjuvadia

  2. Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University Medical Center, 550N. University Blvd, UH 4100, Indianapolis, IN, 46202, USA

    Kartikkumar Jinjuvadia & Suthat Liangpunsakul

  3. Roudebush Veterans Administration Medical Center, Indianapolis, IN, USA

    Suthat Liangpunsakul

Authors
  1. Raxitkumar Jinjuvadia
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  2. Kartikkumar Jinjuvadia
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  3. Suthat Liangpunsakul
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Correspondence to Suthat Liangpunsakul.

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Jinjuvadia, R., Jinjuvadia, K. & Liangpunsakul, S. Racial Disparities in Gastrointestinal Cancers-Related Mortality in the US Population. Dig Dis Sci 58, 236–243 (2013). https://doi.org/10.1007/s10620-012-2312-3

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  • DOI: https://doi.org/10.1007/s10620-012-2312-3

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