Esophageal Cancer Epidemiology in Blacks and Whites: RESULTS part 2
Age-Adjusted Mortality
For the period 1991-2000, the overall age-adjusted esophageal cancer (Arimidex canadian is used to treat breast cancer) mortality rate (MR) was 4.27 (data not shown). Moreover, for the same period, the age adjusted mortality rate observed for blacks (MR=7.79) is nearly twice that for whites (MR=3.96, p<0.05) and that for males is significantly higher than the rate observed for females (MR=1.80 vs. 7.52 for males, p<0.05). For the same period, the age-adjusted mortality rate for black males (MR=13.72) is about twice as high as that observed for white males (MR=7.03, p<0.05), and higher age-adjusted mortality rates are also observed for black females compared to white females. Compared with the five-year period 1991-1995, for the period 1996-2000, the age-adjusted mortality rate is higher overall (4.34 vs. 4.21, p<0.05), and higher for whites (4.12 vs. 3.79, p<0.05) and males (7.62 vs. 7.41, p<0.05) and lower for blacks (7.02 vs. 8.68, p<0.05). Although a decrease in esophageal cancer (Canadian Nolvadex is an anti-estrogen used to treat or prevent breast cancer) mortality is observed among blacks (both males and females), in black males, mortality remains significantly higher than whites.
For the period 1991-2000, trends in age-adjusted mortality rates show decreasing rates overall (EAPO0.65, p<0.05) and in blacks (EAPO-4.04, p<0.05) and increasing rates in whites (EAPOl.74, p<0.05) (data not shown). Age-adjusted mortality rates for the four race-gender groups are presented in Figure 3 for individual years 1991-2000. Between the period 1991-2000, the trends in age-adjusted mortality rates for black males (EAPC=-4.41, p<0.05) and black females (EAPC=-3.06, p<0.05) show declining rates, whereas, for the same period, the trends for white males (1.78, p<0.05) and white females (EAPC=0.87, p<0.05) show increasing rates.
Figure 3. Esophageal cancer age-adjusted mortality rates by race and gender, 1991-2000
Mortality rate ratios are provided in Table 2. Mortality is significantly higher for blacks of both sexes (RR=1.97) than for whites. In addition, males had four-fold greater mortality than females (RR=4.18). Black females have more than twice the mortality of white females.
Table 2. Age-adjusted rate ratios (RR) of mortality rates for race and gender over selected time periods
| Ratios | 1991 | -2000 | 1991- | -1995 | 1996-2000 | |
|
RR |
95% CI | RR | 95% CI | RR |
95% CI |
|
| Blacks to Whites^ Both genders Males Females | 1.97 1.95 2.25 | (1.94, 2.00) (1.92, 1.99) (2.18, 2.32) | 2.29* 2.30* 2.51* | (2.24, 2.34) (2.24, 2.36) (2.40, 2.62) | 1.70* 1.67* 2.05* | (1.66, 1.74) (1.62, 1.71) (1.96, 2.14) |
| Males to Females^ Both races Blacks Whites | 4.18 3.76 4.34 | (4.12, 4.23) (3.64, 3.88) (4.27, 4.41) | 4.14 3.92* 4.28* | (4.06, 4.22) (3.74, 4.10) (4.19, 4.38) | 4.21
3.60* 4.43* |
(4.13, 4.29) (3.43, 3.77) (4.34, 4.52) |
| t The rate ratios are all significantly different than 1 (p<0.05); J The rate ratios differ for time periods 1991-1995 and 1996-2000 (x2 statistic, df=l, p<0.05); Source: Surveillance, Epidemiology and End Results (SEER) Program SEER*Stat Database: Mortality—All COD, Public-Use With State, Total U.S. (1969-2000), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2003. Underlying mortality data provided by NCHS. | ||||||
Relative Survival Rates
The overall five-year relative survival rates are poor for both racial groups and for males and females (data not shown). Survival rates of blacks are lower than of whites (6% vs. 12% in whites, p<0.05, for period 1991-2000). Few differences are observed in survival rates by gender within each racial group. Black males and females have survival rates (6% for black males and 7% for black females) that are lower than those for white males (11%) and females (12%). Trends in survival from this disease have not significantly improved over the decade.
Table 3. Esophageal cancer histology by race and gender, 1991-2000
| Esophageal Cancer Cell Type | Race and Gender |
Total |
||
| Black Female |
Black Male |
White Female |
White Male |
|
| Adenocarcinoma 26 (5%) Squamous cell carcinoma 432 (86%) Other 47 (9%) Total 505 | 74 (6%) 984 (85%) 100 (9%) 1158 | 643 (28%) 1326 (59%) 297 (13%) 2266 | 3859 (61%) 2000 (31%) 510 (8%) 6369 | 4,742 4,602 954 10,298 |
| X2 statistic (df=6) for association is statistically significant (pO.001); Source: Surveillance, Epidemiology and End Results (SEER) Program SEER*Stat Database: Incidence—SEER 9 Regs Public-Use, November 2002 Sub (1973-2000), National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch, released April 2003, based on the November 2002 submission. | ||||
Histology
Esophageal cancer (Generic Casodex treating prostate cancer) histology data by race and gender are presented in Table 3, and the age-adjusted incidences by cell type for race and gender for consecutive two-year intervals are displayed in Figure 4. For the period 1991-2000, blacks (males and females) and white females were proportionally more likely to be diagnosed with squamous cell carcinoma than adenocarcinoma (Table 3). During the same time period, white males were more likely to be diagnosed with adenocarcinoma than squamous cell carcinoma (Table 3). Furthermore, the age-adjusted incidence by cell type for race and gender indicates an increasing trend of adenocarcinoma among white males (Figure 4).
Figure 4. Esophageal cancer age-adjusted incidence by cell type for race by gender for consecutive two-year interval, 1991-2000