Racial disparities on incidence and survival in Kaposi sarcoma during the post-retroviral era: A Surveillance, Epidemiology and End Results program database (2000-2021) retrospective analysis.

Abstract

e23570 Background: Kaposi Sarcoma is most observed in patients with human immunodeficiency virus (HIV). With the advent of the HAART, the incidence and prognosis of KS has significantly improved. However, prior literature reports racial differences in the incidence and survival rates of patients with KS. The purpose of this study was to examine disparities on incidence and on five-year survival rates of KS patients per racial group in the US using the SEER (Surveillance, Epidemiology, and End Results) database from 2000 to 2021. Methods: SEER-17 data from 2000 to 2021 were used to estimate Kaposi Sarcoma incidence and five-year survival by race/ethnicity groups (non-Hispanic White, Black, Hispanic, Asian/Pacific Islander, American Indian/Alaskan Native and Other). A Kaplan-Meier analysis was conducted to compare survival in months between the race/ethnicity groups. A Log rank test and pairwise log rank comparisons with a Bonferroni correction (statistical significance accepted at the p < .003 level) were conducted to determine the difference between such groups. Results: The highest age-adjusted incidence rate was reported for the Black group at 2.3 per 100,000 (95% CI, 2.2 to 2.4), followed by the Hispanic group at 1.3 (95% CI, 1.3 to 1.4), American Indian/Alaska Native at 0.9 per 100,000 (95% CI, 0.7 to 1.2), Non-Hispanic White at 0.8 per 100,000 (95% CI, 0.7 to 0.8) and Asian/Pacific Islander 0.4 (95% CI, 0.3 to 0.4). Individuals who identified as Black had a median survival time in months of 108.0 (95% CI, 90.3 to 125.7 months). This was shorter than the groups of people who identified as non-Hispanic White (159.0 months [95% CI, 145.6 to 172.4 months]), Hispanic (182.0 months [95% CI, 158.1 to 205.9 months]) and Pacific Islander (186.0 months [95% CI, 157.5 to 214.5]) A log rank test determined that the survival distributions for race/ethnicity groups were significantly different, χ 2 (5) = 148.166, p = .000. Corrected Log rank pairwise comparisons showed a statistically significant difference in survival distributions between Black and non-Hispanic White groups (χ 2 (1) = 45.705, p = .000), between Black and Hispanic groups (χ 2 (1) = 42.173, p = .000) and between Black and Asian/Pacific Islander groups (χ 2 (1) = 9.708, p = .002). Conclusions: According to this retrospective analysis, disparities among racial groups persist despite access to healthcare services and the widespread availability of HAART. More research is needed on these vulnerable groups in order to fill the gaps that may impact long-term survival and prognosis.