The Association between Race/Ethnicity and Cancer Stage at Diagnosis of Bone Malignancies: A Retrospective Cohort Study

Abstract

Introduction and objective: Limited data exists analyzing disparities in diagnosis regarding primary bone neoplasms (PBN). The objective of our study was to determine if there is an association between race/ethnicity and advanced stage of diagnosis of PBN. Methods: This population-based retrospective cohort study included patient demographic and health information extracted from the National Cancer Institute Surveillance, Epidemiology, and End Results Program (SEER). The main exposure variable was race/ethnicity categorized as non-Hispanic white (NH-W), non-Hispanic black (NH-B), non-Hispanic Asian Pacific Islander (NH-API), and Hispanic. The main outcome variable was advanced stage at diagnosis. Age, sex, tumor grade, type of bone cancer, decade, and geographic location were co-variates. Unadjusted and adjusted logistic regression analyses were conducted calculating odds ratios (OR) and corresponding 95% confidence intervals. Results: Race/ethnicity was not statistically significantly associated with advanced-stage disease. Adjusted OR for NH-B was 0.94 (95% CI: 0.78–1.38), for NH-API 1.07 (95% CI: 0.86–1.33) and for Hispanic 1.03 (95% CI: 0.85–1.25). Conclusions: The lack of association between race and advanced stage of disease could be due to high availability and low cost for initial management of bone malignancies though plain radiographs. Future studies may include socioeconomic status and insurance coverage as covariates in the analysis.