Racial, geographical, and socioeconomic disparities in patients with rare tumors: SEER database analysis.

Abstract

e23076 Background: Socioeconomic disparities are recognized as significant contributors to variations in healthcare outcomes, influencing access to treatment, disease progression, and survival rates. Rare tumors significantly impact cancer mortality, yet disparities in outcomes remain understudied. Racial and socioeconomic inequities drive unequal access to care and survival rates. Using the SEER database, we analyzed these disparities to uncover gaps in equity. Our findings emphasize the urgent need for targeted interventions. Methods: Surveillance, Epidemiology, and End Results (SEER) database was used using the SEER registry “17 Nov 2023 Sub (2000-2021)”. Rare tumors are typically defined based on low incidence rates, often using a threshold of < 15 cases per 1,000,000 person-years as per the National Cancer Institute (NCI) criteria. Key variables analyzed included age, sex, socioeconomic status, survival duration, time from diagnosis to treatment, and treatment modalities. Statistical analyses were performed,including descriptive statistics and ANOVA to evaluate differences in treatment delays and survival across racial, socioeconomic, and geographic groups. Effect sizes (\u03b7²) and 95% confidence intervals were calculated to quantify disparities and assess trends. Results: We analyzed 410,465 patients with rare tumors to assess racial, socioeconomic, and geographic disparities in treatment and outcomes. Among them, 241,643 (58.9%) were female, and 168,822 (41.1%) were male. Invasive ductal carcinoma of the breast was the most prevalent tumor (23.6%). White patients had shorter delay (21.92±30.10 days, p < 0.001) as compare to Black (mean: 26.05±36.52 days) and American Indian patients (25.59±35.60 days). Socioeconomic disparities were significant, with patients earning < $40,000 experiencing shorter delays but reduced access to advanced treatments compared to higher-income groups. Marital status impacted access, with separated (25.75±34.11 days) and divorced (24.29±33.12 days) patients facing longer delays (p < 0.001). Geographic inequities revealed patients in nonmetropolitan areas had fewer treatment options and lower survival (46.48±49.70 months) compared to those in large metropolitan areas (56.56±55.52 months, p < 0.001). Black patients had the lowest survival (50.68±51.42 months) versus White (54.96±54.91 months) and Asian (54.79±53.50 months) patients (p < 0.001). These findings underscore significant disparities in care and outcomes, highlighting the urgent need for equitable access to timely and advanced treatments. Conclusions: Socioeconomic disparities significantly influence survival, time from diagnosis to treatment, and treatment modalities in rare tumor patients, highlighting the need to address inequities to improve outcomes. Keywords: Rare tumors, socioeconomic disparities, survival duration, treatment modalities