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Survival Disparities Seen in Hispanic Patients With Blood Cancers Living Near the United States/Mexico Border


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A study by Bencomo-Alvarez et al investigating the incidence and survival for Hispanic patients with hematologic malignancies living along the United States/Mexico border in El Paso, Texas, has found that those patients with acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myeloid leukemia had lower overall survival than those living in other parts of the state. The study is being presented at the American Association for Cancer Research Virtual Annual Meeting II (Abstract 4343).

Cancer is the leading cause of death among Hispanics and Latinos in the United States. In 2018, an estimated 149,100 Hispanic patients were diagnosed with cancer and 42,700 died from their disease.

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Study Methodology

The researchers used data from the Texas Cancer Registry to examine the incidence and mortality of 62,756 patients diagnosed with hematologic malignancies in the state of Texas between 1995 and 2016. The cancers they focused on included chronic and acute leukemias, both myeloid and lymphoid; myelodysplastic syndrome (MDS); and myeloproliferative neoplasms (MPNs). Of these patients, 10,822 identified as Hispanic, and 42,756 identified as non-Hispanic white. Data from other races were excluded because of low incidence in the analyzed regions.

Survival for Hispanic and non-Hispanic white patients was compared using the log-rank test and Cox regression analysis adjusting for age and diagnosis.

Study Findings

The researchers found that Hispanic patients were diagnosed with cancer at a significantly younger age in all diseases analyzed (P < .0001). In unadjusted analyses, Hispanics had significantly better overall survival than non-Hispanic white patients diagnosed with myeloid malignancies (P < .0001), but no significant differences for patients with other types of leukemia. After adjusting for age, the researchers found a clear disparity in overall survival for Hispanic vs non-Hispanic white patients with acute lymphoblastic leukemia (ALL, P < .0001) and acute promyelocytic leukemia (APL, P = .03), with no significant differences in other diseases.

The researchers also compared Hispanic patients diagnosed in El Paso vs Hispanic patients from other parts of Texas. They found that Hispanic patients from El Paso had lower overall survival rates when compared to Hispanic patients living in other areas of Texas for ALL (P = .0164), acute myeloid leukemia (AML, P < .0001), and chronic myeloid leukemia (CML, P = .016).

KEY POINTS

  • Hispanic patients living in Texas diagnosed with acute myeloid leukemia, acute lymphoblastic leukemia, or chronic myeloid leukemia had lower overall survival than non-Hispanic white patients, and Hispanic patients living along the United States/Mexico border in El Paso, Texas, had lower overall survival than those patients living in other parts of the state.
  • Hispanic patients had more comorbidities, a general lack of health insurance, and worse socioeconomic status compared with non-Hispanic patients.

Conclusion

“Hispanics are diagnosed at a significantly younger age compared to non-Hispanics,” said lead study author Alfonso Bencomo-Alvarez, PhD, a postdoctoral research associate at Texas Tech University Health Sciences Center, El Paso, during a press briefing. “Hispanic patients with ALL or APL have a worse overall survival compared with non-Hispanic whites. Hispanics with ALL, AML, CML, or MDS diagnosed near the U.S./Mexico border demonstrate worse overall survival compared with Hispanics diagnosed elsewhere in Texas. In general, Hispanics had more comorbidities, a general lack of health insurance, and worse socioeconomic status compared with non-Hispanics. Disparities in outcome caused by ethnicity is different in El Paso compared with the rest of Texas.”

Disclosure: Funding for this research was provided by the National Institutes of Health and Texas Tech University Health Sciences Center. For full disclosures of the study authors, visit abstractsonline.com.


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