Graduation Year

2016

Document Type

Thesis

Degree

M.S.P.H.

Degree Name

MS in Public Health (M.S.P.H.)

Degree Granting Department

Epidemiology and Biostatistics

Major Professor

Hung N. Luu, MD, Ph.D.

Co-Major Professor

Janice Zgibor, R.Ph, Ph.D.

Committee Member

Skai Schwartz, Ph.D.

Keywords

Sarcoma, Disparities, Mortality, Hazard, Annual Percentage Change, SEER

Abstract

Purpose

Our objectives were to 1) determine the difference in Rhabdomyosarcoma (RMS) incidence and survival between different race/ethnicity groups, and 2) evaluate the difference in survival of RMS between children and adults of these race/ethnicity groups, using the Surveillance, Epidemiology, and End Results Program (SEER) database between 1973-2013.

Patients and Methods

We analyzed racial characteristic and incidence data from 4,280 patients diagnosed with RMS, between 1973-2013, that were reported to the SEER database. Survival and hazard analyses were conducted on 4,268 patients with known follow-up data, with end point being death from any cause.

Results

Over the 40-year study period overall RMS incidence rates have experienced a statistically significant decline (APC: -0.78, 95% CI: -1.28 – -0.28). Whites have experienced a significant decline in incidence rates (APC: -1.05, 95% CI: -1.60 – -0.50). Though not statistically significant, incidence rates in Blacks and Hispanics have trended upwards. While adjusted survival was not predicted by race, survival did significantly differ among racial/ethnic groups in children, with Hispanics and “Others” having the lowest 5- and 10-year survival rates (65% and 58% verses 58% and 56%, respectively). Black race/ethnicity was also shown to be a predictor for mortality for the time period 1990-2013.

Conclusion

Racial/ethnic minorities have worse RMS clinical presentation and incidence rates than Whites. While overall survival is not predicted by race, being an ethnic minority child diagnosed with RMS is predictive of survival. These disparities point towards a genetic component in RMS that has not yet been described.

Available for download on Saturday, December 09, 2017

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