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Journal of Racial and Ethnic Health Disparities

, Volume 6, Issue 5, pp 1035–1043 | Cite as

Racial Disparity in Incidence and Survival for Gastrointestinal Stromal Tumors (GISTs): an Analysis of SEER Database

  • Mark B. UlanjaEmail author
  • Mohit Rishi
  • Bryce D. Beutler
  • Kenneth G. Konam
  • Santhosh Ambika
  • Tomas Hinojosa
  • Francis T. Djankpa
  • Wei Yang
  • Nageshwara Gullapalli
Article
  • 74 Downloads

Abstract

Background

Gastrointestinal tumors (GISTs) represent the most common mesenchymal tumors of the gastrointestinal tract. There has been limited data on GIST incidence and survival disparities between ethnic groups.

Aims

Assess disparities in incidence and survival among race in the USA in the era of available GIST histologic codes and treatment.

Methods

We queried Surveillance, Epidemiology, and End Results (SEER) database for GIST from 2002 to 2015, with diagnostic code 8936.

Results

Of the 7204 patients identified, 4928 (68.4%) were White, 1308 (18.2%) African American (AA), and 968 (13.4%) were classified as “Other” (American Indian/Alaskan Native, Asian/Pacific Islander). The overall incidence rate (IR) was 0.75 per 100,000. IR was highest among AA at 1.37/100,000, but 0.65/100,000 for Whites, 1.10/100,000 for Asians/Pacific Islanders, and 0.28/100,000 for American Indians/Alaskan Natives. The GIST incidence was twice as high for AA as for Whites (rate ratio [RR]: 2.12; 95% CI: 1.98–2.26; p < 0.001). There was higher proportion of Whites than AA, who underwent surgical extirpation. Median overall survival (OS) and GIST specific survival (GSS) were not reached for all race, which indicates more than half of the patients were still alive at end of follow-up period. In multivariate Cox model, belonging to “Other” had better OS (adjusted hazard ratio [aHR]; 0.73, 95% CI: 0.55–0.95, P = 0.021) for GIST, but no difference in prognosis and OS for AA and White [(aHR for whites; 0.84, 95% CI: 0.69–1.02, P = 0.071), AA = reference]. There was no difference in GSS among races.

Conclusions

Significant racial disparity in incidence and overall survival for GIST exists, and efforts should be made to bridge this gap and improve outcomes for all races. The overall incidence rate for GIST was noted to be 7.5 per 1 million, and IR of GIST was twice as high for African Americans as compared to Whites. The “Other” racial group (American Indians/Alaskan Natives, Asians, and Pacific Islanders) had superior OS as compared to African Americans and Whites.

Keywords

Surveillance epidemiology and end results Gastrointestinal stromal tumors Race disparity Median survival Incidence rate Incidence of GIST 

Notes

Acknowledgments

We are thankful to Paschal Apanga (University of Nevada, Reno) for his help and suggestions.

Authors’ Contribution

MBU, MR, BDB, TH, and GN conceived the idea and prepared manuscript. MR, KGK, MBU drafted the initial manuscript. MBU performed the computations. WY helped with computation and statistical analysis. TD helped with manuscript writing. SA, NG, TH guided the preparation process and writing of the manuscript. All authors read and approved of the manuscript prior to publication.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

There was no IRB approval needed for this research, as it utilizes public, de-identified data.

Supplementary material

40615_2019_605_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 18 kb)

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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  • Mark B. Ulanja
    • 1
    Email author
  • Mohit Rishi
    • 1
  • Bryce D. Beutler
    • 1
  • Kenneth G. Konam
    • 2
  • Santhosh Ambika
    • 1
    • 3
  • Tomas Hinojosa
    • 4
  • Francis T. Djankpa
    • 5
  • Wei Yang
    • 6
  • Nageshwara Gullapalli
    • 1
  1. 1.Department of Internal MedicineUniversity of Nevada, Reno School of MedicineRenoUSA
  2. 2.College of Arts and SciencesVanderbilt UniversityNashvilleUSA
  3. 3.Renown Institute for CancerRenoUSA
  4. 4.VA Sierra Nevada Health Care SystemRenoUSA
  5. 5.Uniformed Services University of the Health SciencesBethesdaUSA
  6. 6.Center for Surveys, Evaluation and Statistics, School of Community Health SciencesUniversity of Nevada, RenoRenoUSA

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