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Pediatric and AYA Sarcomas

(P 274) RACIAL DISPARITIES IN INCIDENCE AND MORTALITY OVER 20 YEARS AMONG AYA PATIENTS WITH SARCOMA IN THE US: A SEER DATABASE ANALYSIS

    Author(s)

  • Chalothorn Wannaphut, MD

    Resident
    University of Hawai`i John A.Burns School of Medicine
    Honolulu, Hawaii, United States

    • Poster Presenter(s)

  • Prapassorn Thirasastr, MD, MS

    Research Scientist
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

    • Co-Author(s)

  • Neeta Somaiah, MD (she/her/hers)

    Professor and Department Chair
    Department of Sarcoma Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Center
    Houston, Texas, United States

Objective: Despite a steady increase in the incidence of cancers in adolescent and young adult (AYAs), the trend of bone sarcoma (BS) and soft tissue sarcoma (STS) remains understudied. We conducted a Surveillance, Epidemiology, and End Results (SEER) database analysis to evaluate the effects of race/ethnicity on the incidence, trends, and mortality among AYA patients with BS and STS.

Methods: AYA cases (aged 15–39) with BS or STS diagnosed between 2000 and 2021 were identified using the SEER research plus data (22 Registries). SEER*Stat (v8.4.4) was used to calculate incidence rates per 100,000 individuals, mortality rates per 100,000 individuals, age-adjusted incidence rates (AAIR), annual percent change (APC), trends, incidence rate ratios (IRR), and survival outcomes compared among racial groups, including Non-Hispanic White (NHW), Non-Hispanic Black (NHB), Non-Hispanic Asian/Pacific Islander (NHAPI), Non-Hispanic American Indian/Alaska Native (NHAIAN) and Hispanic patients. R (v4.3.2) was utilized for survival analysis.

Results: A total of 5,389 and 16,097 new diagnoses of BS and STS were retrieved from the SEER database, with 10,589 (49.3%) patients being female. All BS and STS patients were categorized by race: NHW, NHB, NHAPI, NHAIAN, and Hispanic, comprising 10,601 (49.3%), 3,120 (14.5%), 1,941 (9.0%), 195 (0.9%), and 5,629 (26.3%) cases, respectively. The incidence of BS increased from 0.8 to 0.9 while STS decreased from 2.7 to 2.3 per 100,000 (from 2000 to 2021). NHW had a high incidence of BS and STS in both sexes compared to all other groups. Among NHWs, there were significant decreases in AAIR for STS (APC -3.6 (95% CI -5.6 to -1.5) for males and -5.4 (-8.1 to -2.6) for females), but no statistically significant changes were observed for BS in any racial group. NHBs had an increased mortality from BS (HR 1.31, 95% CI 1.12–1.53, p = 0.006). For STS, NHAIAN patients had higher mortality compared to NHWs (HR 1.37, 95% CI 1.05–1.78, p = 0.02).

Conclusion: We observed some interesting racial trends in AYA. AAIR for STS decreased over time for NHW. Mortality from BS in NHB patients and STS in NHAIAN patients was higher compared to NHW patients. Further studies are needed to understand the reasons behind disparate outcomes and address barriers to care.

Table 1 Racial/ethnic disparities in mortality among patients with bone and soft tissue sarcomas
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