Racial and Socioeconomic Disparities in Malignant Carcinoid Cancer Cause Specific Survival: Analysis of the Surveillance, Epidemiology and End Results National Cancer Registry


Background: This study hypothesized living in a poor neighborhood decreased the cause specific survival inindividuals suffering from carcinoid carcinomas. Surveillance, Epidemiology and End Results (SEER) carcinoidcarcinoma data were used to identify potential socioeconomic disparities in outcome. Materials and
Methods:This study analyzed socioeconomic, staging and treatment factors available in the SEER database for carcinoidcarcinomas. The Kaplan-Meier method was used to analyze time to events and the Kolmogorov-Smirnov test tocompare survival curves. The Cox proportional hazard method was employed for multivariate analysis. Areasunder the receiver operating characteristic curves (ROCs) were computed to screen the predictors for furtheranalysis.
Results: There were 38,546 patients diagnosed from 1973 to 2009 included in this study. The meanfollow up time (S.D.) was 68.1 (70.7) months. SEER stage was the most predictive factor of outcome (ROC areaof 0.79). 16.4% of patients were un-staged. Race/ethnicity, rural urban residence and county level family incomewere significant predictors of cause specific survival on multivariate analysis, these accounting for about 5% ofthe difference in actuarial cause specific survival at 20 years of follow up.
Conclusions: This study found poorercause specific survival of carcinoid carcinomas of individuals living in poor and rural neighborhoods.