Study Finds Racial Disparities in Cancer-Associated Thrombosis

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The incidence of cancer-associated thrombosis (CAT) appears to be higher in Black/African-American patients and lower in Asian/Pacific Islander patients compared with White patients, and this disparity appears to be driven by the incidence of pulmonary embolism (PE), according to research published in Blood Advances.

Researchers conducted a retrospective observational cohort study using the California Cancer Registry, which is linked to the California Patient Discharge Dataset and Emergency Department Utilization database.

Using a large cohort of patients with the 13 most common first primary malignancies between 2005 and 2017, the researchers evaluated the association between race/ethnicity and CAT. Cancer types included breast, prostate, lung, colorectal, bladder, uterine, kidney, pancreatic, stomach, ovarian, and brain cancers as well as non-Hodgkin lymphoma and multiple myeloma. 


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The researchers identified 942,109 patients, of whom 62,003 (6.6%) developed CAT. Most patients were 50 years of age and older, and stage 4 disease was the most common (33.4%) stage at cancer diagnosis. Racial/ethnic differences in neighborhood socioeconomic status (SES) were observed. The proportion of patients residing in lower SES neighborhoods was 71.9% for Black/African-American patients, 74.9% for Hispanic patients, 46.1% for White patients, and 50.4% for Asian/Pacific Islander patients.

Black/African-American patients had the highest 12-month cumulative incidence of CAT for all cancer types, except myeloma (range, 1.90%-15.00%), compared with the other racial/ethnicity groups. The greatest difference was seen in ovarian cancer, where the 12-month cumulative incidence of CAT was 14.0% for Black/African-American patients compared with 9.14% in White patients, 8.30% in Hispanic patients, and 6.06% in Asian/Pacific Islander patients.

The researchers also found that Asian/Pacific Islander patients had the lowest 12-month cumulative incidence of CAT for all cancer types compared with the other racial/ethnicity groups.

The racial/ethnic differences in the incidence of CAT for each tumor type was largely driven by differences in the incidence of PE.

“We speculate the association of race/ethnicity with incidence of CAT may be partially because of underlying thrombotic predisposition that varies by ancestry, but we also must consider the impact of social determinants of health on our results,” the authors wrote. “In our study, race/ethnicity is likely a surrogate for many factors that are not traditionally measured in biomedical studies and should stimulate further research into the reasons for the association of race/ethnicity with this common and serious complication of cancer, with the goal of reducing potential health inequities.”

Reference

Datta T, Brunson A, Mahajan A, Keegan T, Wun T. Racial disparities in cancer-associated thrombosis. Blood Adv. 2022;6(10):3167-3177. doi:10.1182/bloodadvances.2021006209

This article originally appeared on Hematology Advisor



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