Earlier age at diagnosis: another dimension in cancer disparity?

Abstract

Background: The age at diagnosis is of vital consideration for maximizing the benefits of screening recommendations, prevention initiatives, and treatment strategies. The current study compared the age at diagnosis in African Americans (AA) and whites for the 12 most frequently occurring cancers from 1996 to 2002. Using three criteria, this study determined whether cancers in most anatomic sites were more likely to occur at an earlier age in AA than in whites in the United States.

Methods: The Surveillance, Epidemiology, and End Results (SEER) Program was used to collect publicly accessible cancer data from 1996 through 2002 for AA and whites. Frequency, population size, and median age at diagnosis were collected for each of the 12 most commonly occurring cancers. These included: prostate, breast, lung, colon, urinary bladder, corpus uteri, non-Hodgkin's lymphoma, ovary, kidney, leukemia, oral cavity and pancreas. Poisson and logistic regression were used to investigate the possible association between race/ethnicity and an earlier age at cancer diagnosis.

Results: In general, AA had an earlier age at diagnosis for invasive cancer compared with whites. According to the median age at diagnosis, all 12 frequently occurring cancers from 1996 to 2002 were diagnosed significantly earlier in AA than in whites. Eight of the 12 cancers reached an arbitrary rate of >or=3 cases per 100,000 persons at a significantly younger age in AA than in whites. However, the relative risk of a cancer diagnosis for persons 5-45 years of age was significantly greater for only 3 of the 12 cancers in AA.

Conclusion: Cancers in general have an earlier age at diagnosis in AA than in whites. Earlier age at diagnosis may be another indicator of disparity since cancers that arise at a younger age tend to be more aggressive and frequently result in a less favorable outcome.