Special Populations

--Marks JE, Phillips JL, Menck, HR. The National Cancer Data Base report on the relationship of race and national origin to the histology of nasopharyngeal carcinoma. Cancer 1998; 83(3):582-8. (!)

The development of nasopharyngeal carcinoma reflects interactions of genetics, diet, and viral agents. It is more common in Asians than non-Asians, with different characteristic histologic types. This study examined nasopharyngeal carcinoma in the United States as a function of patient origin and histology using data from the National Cancer Data Base. The 5,069 nasopharyngeal carcinoma cases diagnosed between 1985 and 1994 were grouped by histologic type: keratinizing squamous cell, nonkeratinizing, and undifferentiated carcinoma. Patient origin was derived from race, Hispanic ethnicity, and place of birth. World Health Organization (WHO) type 1 keratinizing squamous cell carcinomas comprised 75% of the U.S. nasopharyngeal carcinoma cases and were found most often in U.S.-born, non-Hispanic whites. WHO-2 nonkeratinizing and WHO-3 undifferentiated carcinomas of the nasopharynx comprised the remaining 25% of nasopharyngeal carcinomas and were more common in Asians. Histologic composition varied for each of the 12 patient origin groups in the study and correlated with survival. Asians had the highest portion of radioresponsive WHO-2 nonkeratinizing and WHO-3 undifferentiated carcinomas of the nasopharynx and better survival than African-Americans, Hispanics, and non-Hispanic whites, who had the greatest number of the less radioresponsive keratinizing squamous cell carcinomas of the nasopharynx. The 5-year relative survival was 65% for the nonkeratinizing and undifferentiated carcinomas and 37% for the keratinizing type.

--Parham G, Phillips JL, Hicks ML, Andrews N, Jones WB, Shingleton HM, Menck HR. The National Cancer Data Base report on malignant epithelial ovarian carcinoma in African-American women. Cancer 1997; 80:816-826.

Epithelial ovarian carcinoma is the fifth most common cause of cancer death among African-American women. Although the incidence rate of ovarian carcinoma for whites is higher than that for African-Americans, the relative survival rate for African-Americans is poorer. The data used for this analysis were cases submitted to NCDB for invasive epithelial tumors of the ovary diagnosed between 1985 through 1988 and 1990 through 1993. African-American women with epithelial ovarian carcinoma were compared with non-Hispanic white women with the same disease. The groups of white women with which African-American women were compared were classified as "White-same facility" and "White-other facility". "White-same facility" were white patients from hospitals that contributed a substantial proportion of African-American patients. "White-other facility" were white patients from hospitals that contributed few or no African-American patients. No patients had a prior history of cancer. African-American women with advanced invasive epithelial ovarian carcinoma were less often treated with combined surgery and chemotherapy and more often treated with chemotherapy only. African-American women were twice as likely as white women not to receive appropriate treatment and they had poorer survival rates than white women from the same or different hospitals, regardless of income. Among staged cases, African-American women were more often diagnosed with Stage IV disease than either group of white women. The current study findings show that African-American women with advanced epithelial ovarian carcinoma received less aggressive treatment than white women and had a poorer prognosis.

--Kennedy BJ, Winchester DP, McGinnis LS, Menck HR. Differences in patterns of care for older patients with cancer. In: Steele GD, Jessup JM, Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1995. Atlanta, GA: American Cancer Society, 1995; 113-116.

--Menck HR, Clive RE, Fremgen AM, Ploetz BM. Ethnicity as a predicter of high risk subpopulations. J Registry Management 1995; 22:27-29.

--Freeman HP, Menck HR, Winchester DP. Cancer patterns of care among the poor. In: Steele GD, Winchester DP, Osteen RT, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1994. Atlanta, GA: American Cancer Society, 1994.

--Villar HV, Menck HR. The National Cancer Data Base report on cancer in hispanics. Cancer 1994; 74:2386-2395.

--Villar HV, Menck HR. Cancer in hispanics. In: Steele GD, Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1993. Atlanta, GA: American Cancer Society, 1993; 74-92.

--Zaki A, Natarajan N, Mettlin CJ. Early and late survival in Hodgkin's Disease among whites and blacks living in the United States. Cancer 1993; 72:602-606.

A total of 9482 patients with histologically confirmed Hodgkin's disease were reported by 1,084 hospitals and institutions in the U.S. The independent effect of race on response to treatment and recurrence was estimated using the logistic model. The Cox proportional hazard model was applied to determine the independent effect of race and other co- variables on risk of death. Complete remission occurred in more white patients (67.3%) than African-Americans (58.2%). Recurrences were reported more often in African- American patients than in white patients (40.3% and 30.9% respectively). Controlling for confounding variables, race has a significant independent effect on remission and recurrence (P<0.05). In the first 5 years after diagnosis of Hodgkin's disease, the patient age at diagnosis, clinical stage, and histologic type were significant predictors for the risk of death. At 5-10 years after a diagnosis of Hodgkin's disease, age, clinical stage, and race of the patient were found to be significant risk factors (white versus African-Americans: RR=0.56; P<0.05). Race is a significant predictor for remission, recurrence, and survival in Hodgkin's disease. African-American patients have a less favorable prognosis than white patients.

--Leffall LD, Menck HR, Steele GD, Winchester DP. Special populations. In: Steele GD, Winchester DP, Menck HR, Murphy GP: eds. National Cancer Data Base: Annual review of patient care, 1992. Atlanta, GA: American Cancer Society, 1992; 47-65.

Clinical Infomation Bibliography