Racial disparity in incidence and survival for gastrointestinal stromal tumors (GIST): An analysis of SEER database.

Abstract

11037 Background: Gastrointestinal tumors (GISTs) represent the most common mesenchymal tumors of the gastrointestinal tract. There has been limited data on GISTs incidence and survival disparities between ethnic groups. We assess disparities in incidence and survival among race in the United States in the era of available GIST histologic codes and treatment. Methods: We queried Surveillance, Epidemiology, and End Results (SEER) database for GIST from 2002 to 2015, with diagnostic code 8936. Results: Of the 7,204 patients identified, 4,928 (68.4%) were White; 1,308 (18.2%) African American (AA) and 968 (13.4%) were classified as Other (American Indian/Alaskan Native, Asian/Pacific Islander). The overall incidence rate (IR) was 0.753 per 100,000. IR was highest among AA at 1.372/100,000, but 0.648/100,000 for Whites, 1.075/100,000 for Asians/Pacific Islanders and 0.276/100,000 for American Indians/Alaskan Natives. The GIST incidence was twice as high for AA as for Whites (Rate ratio [RR]: 2.12; 95% CI: 1.98-2.26; p<0.001). Lower proportion of AA underwent surgery as compared to white and Other. Median overall survival (OS) [116 months] and GIST specific survival (GSS) was significantly lower in AA as compared to White and Other. In multivariate Cox model, belonging to Other had better OS (adjusted hazard ratio [aHR]; 0.81, 95% CI: 0.69-0.95, P=0.011) for GIST, but no difference in prognosis and OS for AA and White [(aHR for whites; 0.93, 95% CI: 0.83-1.04, P=0.187), AA=reference]. Conclusions: Significant racial disparity in incidence and survival for GIST exists, and efforts should be made to bridge this gap and improve outcomes for all races. [Table: see text]