ArticleAnnals of surgical oncology2023
Racial Segregation Among Patients with Cholangiocarcinoma-Impact on Diagnosis, Treatment, and Outcomes.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 21 citations in OpenAlex.
- Understanding Cancer Health Disparities.Cancers · 2026Review
- Impact of Race on Admission, Clinical Outcomes, and Disposition in Cholangiocarcinoma: Insights from the National Inpatient Database.Diseases (Basel, Switzerland) · 2025Article
- Trends and disparities in place of death among patients with cholangiocarcinoma: A two-decade analysis.Palliative & supportive care · 2025Article
- Impact of Residential Segregation on Healthcare Utilization and Perceived Quality of Care Among Informal Caregivers in the United States.Journal of racial and ethnic health disparities · 2025Article
- State-Level Tax Policy, Cancer Screening, and Mortality Rates in the US.JAMA network open · 2025Article
- Days at Home After Cancer Surgery: Impact of Area Deprivation and Association with Long-Term Outcomes.Annals of surgical oncology · 2025Article
- Associations of Social Vulnerability and Race-Ethnicity With Gastrointestinal Cancers in the United States.Cancer medicine · 2025Article
- ASO Author Reflections: Contemporary Redlining-Direct and Mediating Effects on Healthcare Disparities Among Patients with Gastrointestinal Cancer.Annals of surgical oncology · 2025Article
- Impact of Contemporary Redlining on Healthcare Disparities Among Patients with Gastrointestinal Cancer: A Mediation Analysis.Annals of surgical oncology · 2025Article
- Forty-five-year trends in intra- and extrahepatic cholangiocarcinoma: sex- and race-based insights.Annals of gastroenterologyArticle
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12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRacial segregation, an effect of historical marginalization, may impact cancer care and outcomes. We sought to examine the impact of racial segregation on the diagnosis, treatment, and outcomes of patients with cholangiocarcinoma (CCA). PATIENTS AND
methodsData on Black and White patients with CCA were obtained from the linked SEER-Medicare database (2004-2015) and 2010 Census data. The index of dissimilarity (IoD), a validated measure of segregation, was used to assess Black-White disparities in stage disease presentation, surgery for localized disease, and cancer-specific mortality. Multivariable Poisson regression was performed, and competing risk regression analysis was used to determine cancer-specific survival.
resultsAmong 7480 patients with CCA, 90.2% (n = 6748) were White and 9.8% (n = 732) were Black. Overall, Black patients were more likely to reside in segregated areas compared with White patients (IoD, 0.42 vs. 0.38; p < 0.05). On multivariable Poisson regression, Black patients were more likely to present with advanced-stage disease [relative risk (RR) 1.17, 95% confidence interval (CI) 1.08-1.27; p < 0.001] and were less likely to undergo surgery for localized disease (RR 0.62, 95% CI 0.51-0.76; p < 0.001). Black patients also had worse cancer-specific survival (CSS) compared with White patients (median CSS: 4 vs. 8 months; p < 0.01). Black patients living in the highest areas of segregation had 40% increased hazard of mortality versus White patients residing in the lowest IoD areas (hazard ratio 1.40, 95% CI 1.10-1.80; p < 0.01).
conclusionRacial segregation, as a proxy for structural racism, had a marked effect on Black-White disparities among patients with CCA.
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