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A SEER (Surveillance, Epidemiology, and End Results) Program Population-Based Study

Limin X. Clegg, PhD; Frederick P. Li, MD; Benjamin F. Hankey, ScD; Kenneth Chu, PhD; Brenda K. Edwards, PhD

Arch Intern Med. 2002;162:1985-1993.

Background  Available cancer statistics pertain primarily to white and African American populations. This study describes racial or ethnic patterns of cancer-specific survival and relative risks (RRs) of cancer death for all cancers combined and for cancers of the colon and rectum, lung and bronchus, prostate, and female breast for the 6 major US racial or ethnic groups.

Methods  Cancer-specific survival rates were analyzed for more than 1.78 million patients who resided in the 9 SEER (Surveillance, Epidemiology, and End Results) Program geographic areas and were diagnosed between 1975 and 1997 as having an incident invasive cancer, by 6 racial or ethnic groups (non-Hispanic whites, Hispanic whites, African Americans, Asian Americans, Hawaiian natives, and American Indians and Alaskan natives).

Results  Survival rates improved between 1988 to 1997 for virtually all racial or ethnic groups. However, racial or ethnic differences in RRs of cancer death persisted after controlling for age for all cancers combined and for age and stage for specific cancer sites (P<.01). African American, American Indian and Alaskan native, and Hawaiian native patients tended to have higher RRs of cancer death than the other groups. American Indians and Alaskan natives generally exhibited the highest RRs of cancer death, except for colorectal cancer in males.

Conclusions  Survival rates in patients with cancer have improved in recent years, but racial or ethnic differences in survival rates and in RRs of cancer death persist. Additional studies are needed to clarify the socioeconomic, medical, biological, cultural, and other determinants of these findings.

From the Surveillance Research Program, Division of Cancer Control and Population Sciences (Drs Clegg, Hankey, and Edwards), and the Center to Reduce Cancer Health Disparities (Dr Chu), National Cancer Institute, Bethesda, Md; and the Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, Mass (Dr Li).

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