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Showing content from https://pubmed.ncbi.nlm.nih.gov/32766799/ below:

Associations of Socioeconomic Status, Public vs Private Insurance, and Race/Ethnicity With Metastatic Sarcoma at Diagnosis

Affiliations

• ¹ Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis.
• ² Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis.
• ³ Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
• ⁴ Division of Biostatistics, University of Minnesota, Minneapolis.

• PMID: 32766799
• PMCID: PMC7414392
• DOI: 10.1001/jamanetworkopen.2020.11087

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Brandon J Diessner et al. JAMA Netw Open. 2020.

• ¹ Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis.
• ² Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Minnesota, Minneapolis.
• ³ Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
• ⁴ Division of Biostatistics, University of Minnesota, Minneapolis.

• PMID: 32766799
• PMCID: PMC7414392
• DOI: 10.1001/jamanetworkopen.2020.11087

Item in Clipboard

Importance: Approximately 10% to 30% of patients with sarcoma present with detectable metastases at diagnosis. However, the extent to which presentation with metastases is due to delayed diagnosis vs other factors remains unclear.

Objective: To evaluate whether socioeconomic status, insurance status, or race/ethnicity were associated with the presence of metastases at diagnosis of sarcoma.

Design, setting, and participants: This cross-sectional study used data from the population-based Surveillance, Epidemiology, and End Results program. Adult and pediatric patients with an initial diagnosis of soft-tissue and bone sarcoma between 2001 and 2015 were stratified by age group (pediatric, <20 years; adult, 20-65 years; older adult, >65 years) and sarcoma subtype. Statistical analyses were performed between August 2019 and January 2020.

Exposures: Surveillance, Epidemiology, and End Results Census tract-level socioeconomic status index, insurance status, and race/ethnicity.

Main outcomes and measures: The odds of presenting with metastases at diagnosis were calculated.

Results: A total of 47 337 patients with first primary malignant sarcoma were included (24 343 male patients [51.4%]), with 29 975 non-Hispanic White patients (63.3%), 5673 non-Hispanic Black patients (12.0%), 7504 Hispanic patients (15.8%), and 4185 American Indian-Alaskan Native and Asian Pacific Islander patients (8.8%). Liposarcoma in adults was the only subtype and age group combination that demonstrated a significant trend in incidence across socioeconomic status levels (odds ratio, 0.85; 99% CI, 0.76-0.96; P = .001). However, compared with having non-Medicaid insurance, having Medicaid or no insurance in adults was associated with an increased odds of metastases at diagnosis for 6 of the 8 sarcoma subtypes evaluated; osteosarcoma and Ewing sarcoma were the only 2 subtypes in adults for which metastases were not associated with insurance status. In addition, there was an increased risk of presenting with metastases among non-Hispanic Black adults diagnosed with leiomyosarcoma (odds ratio, 1.87; 99% CI, 1.41-2.48) and unclassified sarcomas (odds ratio, 1.65; 99% CI, 1.01-2.67) compared with non-Hispanic White adults that was independent of socioeconomic and insurance status.

Conclusions and relevance: These findings suggest that delayed access to care is associated with advanced stage at diagnosis for several soft-tissue sarcoma subtypes in adults, whereas other factors may be associated with the metastatic progression of osteosarcoma and Ewing sarcoma, as well as the racial disparities observed with metastatic leiomyosarcoma and unclassified sarcomas.

PubMed Disclaimer

Conflict of Interest Disclosures: None reported.

All data are adjusted for race, sex, age at diagnosis, and year of diagnosis. ARMS indicates alveolar rhabdomyosarcoma; DSRCT, desmoplastic small round cell tumor; ES, Ewing sarcoma; F/MF, fibroblastic or myofibroblastic; GIST, gastrointestinal stromal tumor; MPNST, malignant peripheral nerve sheath tumor; RMS, rhabdomyosarcoma; and UPS, undifferentiated pleomorphic sarcoma.

All data are adjusted for small-area socioeconomic status (ordinal variable), sex, age at diagnosis, and year of diagnosis. ARMS indicates alveolar rhabdomyosarcoma; DSRCT, desmoplastic small round cell tumor; ES, Ewing sarcoma; F/MF, fibroblastic or myofibroblastic; GIST, gastrointestinal stromal tumor; MPNST, malignant peripheral nerve sheath tumor; RMS, rhabdomyosarcoma; and UPS, undifferentiated pleomorphic sarcoma.

ARMS indicates alveolar rhabdomyosarcoma; DSRCT, desmoplastic small round cell tumor; ES, Ewing sarcoma; F/MF, fibroblastic or myofibroblastic; GIST, gastrointestinal stromal tumor; MPNST, malignant peripheral nerve sheath tumor; RMS, rhabdomyosarcoma; and UPS, undifferentiated pleomorphic sarcoma.

ARMS indicates alveolar rhabdomyosarcoma; DSRCT, desmoplastic small round cell tumor; ES, Ewing sarcoma; F/MF, fibroblastic or myofibroblastic; GIST, gastrointestinal stromal tumor; MPNST, malignant peripheral nerve sheath tumor; RMS, rhabdomyosarcoma; and UPS, undifferentiated pleomorphic sarcoma.

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1. 1. Helman LJ, Meltzer P. Mechanisms of sarcoma development. Nat Rev Cancer. 2003;3(9):685-694. doi:10.1038/nrc1168 - DOI - PubMed
2. 1. Miller BJ, Cram P, Lynch CF, Buckwalter JA. Risk factors for metastatic disease at presentation with osteosarcoma: an analysis of the SEER database. J Bone Joint Surg Am. 2013;95(13):e89. doi:10.2106/JBJS.L.01189 - DOI - PMC - PubMed
3. 1. Ramkumar DB, Ramkumar N, Miller BJ, Henderson ER. Risk factors for detectable metastatic disease at presentation in Ewing sarcoma: an analysis of the SEER registry. Cancer Epidemiol. 2018;57:134-139. doi:10.1016/j.canep.2018.10.013 - DOI - PubMed
4. 1. Italiano A, Mathoulin-Pelissier S, Cesne AL, et al. . Trends in survival for patients with metastatic soft-tissue sarcoma. Cancer. 2011;117(5):1049-1054. doi:10.1002/cncr.25538 - DOI - PubMed
5. 1. Cotterill SJ, Ahrens S, Paulussen M, et al. . Prognostic factors in Ewing’s tumor of bone: analysis of 975 patients from the European Intergroup Cooperative Ewing’s Sarcoma Study Group. J Clin Oncol. 2000;18(17):3108-3114. doi:10.1200/JCO.2000.18.17.3108 - DOI - PubMed

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