Table 2.
The Impact of Co-Morbid Medical Conditions.
| Years of study, Reference | Population | Outcome | Race Groupings | HR, 95% CI | Disparity |
|---|---|---|---|---|---|
| 1999-2004, Beebe-Dimmer et al. (32) |
HFHS1
N=637 cases, 244 controls |
Association between metabolic syndrome (MetS) and prostate cancer | MetS and prostate cancer: | Odds Ratio: | Metabolic syndrome associated with prostate cancer risk in Black men with organ confined disease. Obesity protective for White and not Black men. |
| Black | 1.71 (0.97-3.01) | ||||
| White | 1.02 (0.64-1.62) | ||||
| Organ confined with MetS: | |||||
| Black | 1.82 (1.02-3.23) | ||||
| White | 1.01 (0.63-1.62) | ||||
| Advanced with MetS | |||||
| Black | 0.93 (0.31-2.77) | ||||
| White | 1.17 (0.55-2.51) | ||||
| Obesity | |||||
| Black | 1.15 (0.70-1.89) | ||||
| White | 0.51 (0.33-0.8) | ||||
| 2010-2011, Bandera et al. (35) | AACES2
N=492 cases, 696 controls All Black participants |
Impact of BMI3 1yr pre-diagnosis and weight gain since age 18 on ovarian cancer risk | Ovarian cancer risk BMI ≥40 | Odds Ratio | Ovarian cancer risk associated with higher BMI and weight gain in study of Black postmenopausal women. |
| 1.72 (1.12-2.66) | |||||
| Ptrend 0.03 | |||||
| Weight gain since age 18 | 1.52 (1.07-2.16) | ||||
| Ptrend 0.02 | |||||
| 2002-2007, Colt et al. (31) |
USKCS4
Cases: 843 White and 358 Black; Controls: 707 White and 519 Black |
Role of hypertension in renal cell cancer incidence by race | HTN risk: | Odds Ratio | Higher risk of renal cell carcinoma for Black vs. White patients with HTN and consistent risk with prolonged or poorly controlled HTN. |
| Black | 2.8 (2.1-3.8) | ||||
| White | 1.9 (1.5-2.4) | ||||
| Risk after 25 years of HTN: | |||||
| Black | 4.1 (2.3-7.4) | ||||
| White | 2.6 (1.7-4.1) | ||||
| Ptrend <0.001 | |||||
| Risk with poorly controlled HTN: | |||||
| Black | 4.5 (2.3-8.8) | ||||
| White | 2.1 (1.2-3.8) | ||||
| Ptrend<0.001 | |||||
| Callahan et al. (36) | USKCS N=965 cases, 953 controls KPNC5: N=2162 cases, 21,484 controls |
Race and gender-specific PAR% for hypertension and CKD based on race, age ≥50 years | Hypertension (USKC): | PAR%6: | Black compared with White patients had larger population attributable risk percent associated with HTN and chronic kidney disease. |
| Black male | 44.4% (24.7-64.1%) | ||||
| White male | 26.6% (14.2-39%) | ||||
| Black female | 50% (23.5-76.7%) | ||||
| White female | 28.5% (13.4-43.64%) | ||||
| Hypertension (KPNC): | |||||
| Black male | 22.8% (1.6-44.1%) | ||||
| White male | 18.9% (13.7-24.1%) | ||||
| Black female | 39.8% (17.5-62.2%) | ||||
| White female | 27.4% (20.3-34.5%) | ||||
| CKD7 (USKC): | |||||
| Black male | 9.4% (4.0-14.8%) | ||||
| White male | 0.6% (-0.5-1.6%) | ||||
| Black female | 8.4% (1.9-14.9%) | ||||
| White female | 0.4% (-1.5-2.3%) | ||||
| CKD (KPNC): | |||||
| Black male | 10.1% (4.6-15.5%) | ||||
| White male | 0.0% (-0.6-0.5%) | ||||
| Black female | 6.9% (1.5-12.4%) | ||||
| White female | -0.3% (-0.8-0.1%) | ||||
| 1986-1989 Silverman et al. (38) |
SEER registries: Atlanta, Detroit, and New Jersey N=526 cases, 2,153 controls |
Role of comorbidities in pancreatic cancer incidence by race | PAR %- smoking, diabetes, family history: | PAR%: | The known pancreatic risk factors accounts for some of the difference in risk for Black and White men, however a larger proportion of the difference in risk is accounted for by less known risk factors in Black and White women. |
| Black male | 46% (10-82%) | ||||
| White male | 37% (13-62%) | ||||
| Black female | 15% (13-43%) | ||||
| White female | 27% (4-49%) | ||||
| PAR% adding heavy alcohol use, high BMI: | |||||
| Black male | 53% (13-93%) | ||||
| White male | 49% (23-74%) | ||||
| Black female | 88% (66-111%) | ||||
| White female | 47% (2-92%) | ||||
| 2000-2005 Olson et al. (37) |
SEER8
Medicare: N=11,610 White, and 958 Black; age ≥ 66 years |
Influence of co-morbidities on overall survival in endometrial cancer | OS9: | Multivariate | Black-white differences in OS and DSS in multivariable analysis remained after adjusting for co-morbidities |
| Black vs. White | 1.16 (1.05-1.28) | ||||
| DSS10 | |||||
| Black vs. White | 1.27 (1.08-1.49) | ||||
| 1990-2005, Ruterbusch et al. (22) | HFHS N=627 |
Influence of comorbid conditions on survival: endometrial cancer |
Black vs. White: | Multivariate | No Black-White differences in overall survival, but continued differences in disease specific survival after adjusting for clinical factors and co-morbid conditions |
| Death from any cause | 1.22 (0.94-1.57) | ||||
| Death from endometrial cancer | 2.27 (1.39-3.68) | ||||
| 1996-2012, Cote et al. (21) | KCC11: N=97 White & 89 Black |
Post-surgical outcomes, survival in very obese women (BMI ≥40): endometrial cancer |
Overall Survival | Multivariate | Black-White difference in post-op complications but no differences in overall or disease-specific survival after adjusting for age, histology, FIGO stage and grade, treatment and comorbidities. |
| Black vs. White | 0.85 (0.36-2.03) | ||||
| Disease specific survival | |||||
| Black vs. White | 0.95 (0.26-3.52) |
•All statistics other than hazard ratios are indicated in the table.
1HFHS, Henry Ford Health System.
2AACES, African American Cancer Epidemiology Study.
3BMI, Body Mass Index.
4USKCC, US Kidney Cancer Study.
5KPNC, Kaiser Permanente Northern California.
6PAR%, Population attributable risk percent.
7CKD, Chronic kidney disease.
8SEER, Surveillance, Epidemiology and End Results Program.
9OS, Overall survival.
10DSS, Disease specific survival.
11KCC, Karmanos Cancer Center.