title: Age at cancer diagnosis, amenability to medical interventions, and racial/ethnic disparities in cancer mortality.
abstract: OBJECTIVE
  Racial disparities in cancer mortality may be greater for cancers that are amenable to available early detection and treatment (amenability level). We investigated whether these patterns vary by age at cancer diagnosis.
  
  
  METHODS
  Using 5-year relative survival rates (5Y-RSR), we classified 51 cancer sites into least amenable, partly amenable, and mostly amenable cancers (<40%, 40-69%, ≥70% 5-YRS, respectively). We examined whether racial disparities in mortality rates (African-Americans, Asian/Pacific Islanders, Hispanics, whites), as estimated through Cox regression models, were modified by age at diagnosis and amenability level in 516,939 cancer cases diagnosed in 1995-1999.
  
  
  RESULTS
  As compared with whites, all racial minority groups experienced higher cancer mortality rates in the youngest age group of 20-34 years. African-Americans and Hispanics diagnosed with partly and mostly amenable cancers had higher mortality rates relative to whites with cancers of the same amenability levels; further, these differences decreased in magnitude or reversed in direction with increasing age. In contrast, the racial differences in mortality were smaller and remained fairly constant across age groups for least amenable cancers. For example, in the youngest (20-34) and oldest (80-99) age groups, the adjusted hazard ratios (HRs) for African-Americans versus whites with least amenable cancers were, respectively, 1.26 (95% CI 1.02, 1.55) and 0.90 (95% CI 0.85, 0.96), while the HRs for African-Americans versus whites with mostly amenable cancers were 2.77 (95% CI 2.38, 3.22) and 1.07 (95% CI 0.98, 1.17).
  
  
  CONCLUSIONS
  Cancer survival disadvantage for racial minorities is larger in younger age groups for cancers that are more amenable to medical interventions.
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA. pt140@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA. pt140@columbia.edu.
authors.forename: Parisa
authors.initials: P
authors.lastname: Tehranifar
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Abhishek
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Jo C
authors.initials: JC
authors.lastname: Phelan
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.|Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.|Department of Public Policy, University of California Riverside, Riverside, CA, USA.
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Link
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Yuyan
authors.initials: Y
authors.lastname: Liao
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Xiaozhou
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Medicine, Division of General Medical Disciplines, Stanford University, Palo Alto, CA, USA.
authors.forename: Manisha
authors.initials: M
authors.lastname: Desai
authors.affiliation: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.|Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, NY, USA.|The Imprints Center for Genetic and Environmental Lifecourse Studies, Columbia UniversityMailman School of Public Health, New York, NY, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology* / Q000401:mortality; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Age; Cancer mortality; Medical advances; Racial/ethnic disparities; Survival factors