White-Black Differences in Cancer Incidence, Stage at Diagnosis, and Survival among Adults Aged 85 Years and Older in the United States

Abstract

Background: Increased life expectancy, growth of minority populations, and advances in cancer screening and treatment have resulted in an increasing number of older, racially diverse cancer survivors. Potential black/white disparities in cancer incidence, stage, and survival among the oldest old (≥85 years) were examined using data from the SEER Program of the National Cancer Institute.

Methods: Differences in cancer incidence and stage at diagnosis were examined for cases diagnosed within the most recent 5-year period, and changes in these differences over time were examined for white and black cases aged ≥85 years. Five-year relative cancer survival rate was also examined by race.

Results: Among those aged ≥85 years, black men had higher colorectal, lung and bronchus, and prostate cancer incidence rates than white men, respectively. From 1973 to 2012, lung and bronchus and female breast cancer incidence increased, while colorectal and prostate cancer incidence decreased among this population. Blacks had higher rates of unstaged cancer compared with whites. The 5-year relative survival rate for all invasive cancers combined was higher for whites than blacks. Notably, whites had more than three times the relative survival rate of lung and bronchus cancer when diagnosed at localized (35.1% vs. 11.6%) and regional (12.2% vs. 3.2%) stages than blacks, respectively.

Conclusions: White and black differences in cancer incidence, stage, and survival exist in the ≥85 population.

Impact: Continued efforts are needed to reduce white and black differences in cancer prevention and treatment among the ≥85 population. Cancer Epidemiol Biomarkers Prev; 25(11); 1517-23. ©2016 AACR.

Figure 1

Incidence trends of colorectal, lung and bronchus, breast, and prostate cancer among men and women aged ≥85 years, 1973–2012.

Figure 2

Incidence trends of colorectal, lung and bronchus, breast, and prostate cancer among white and black adults aged ≥85 years, 1973–2012.

Figure 3

Cancer staging among white and black adults aged ≥85 years, diagnosed 2008 to 2012.

Figure 4

Five-year relative survival rate for selected invasive cancers by stage at diagnosis, among white and black adults aged ≥85 years and diagnosed 2005 to 2011.