Racial and socioeconomic disparities in ocular surface squamous neoplasia: a National Cancer Database analysis

ABSTRACT

Purpose

A retrospective population-based study to investigate racial and socioeconomic disparities in patients diagnosed with ocular surface squamous neoplasia (OSSN).

Methods

To explore racial disparity, we selected OSSN patients with known age, insurance, gender and zip code-level income and education from the National Cancer Database (NCDB). Comparisons of clinical and socioeconomic variables stratified by race were made with the chi-square or Mann-Whitney tests. Survival outcome was examined a Cox regression model.

Results

Of the 2,402 identified patients from 2004 to 2015, 117 were black. Unadjusted differences were found between groups in regard to age, histology, insurance, income, and education. Black patients in comparison to white patients were younger (mean age: 62 years vs. 70 years; p < .001), represented a higher proportion of Medicaid use (10.3% vs. 3.2%; p < .001) or uninsured (10.3% vs. 2.7%; p < .001), and were more likely to reside in areas of low educational attainment (32.5% vs. 16.1% of whites; p < .001). Multivariate analysis found significantly higher risk of death in patients who were male (HR: 1.66, 95% CI 1.37–2.01) or black (HR: 1.57, 95% CI 1.03–2.38).

Conclusion

Disparities in socioeconomic factors were observed in black patients with OSSN. OSSN occurred earlier in blacks, who were also socioeconomically disadvantaged and faced higher risk of death.

KEYWORDS:

• Public health
• cancer research
• eye cancer
• racial disparities

Financial Support

Not applicable

Disclosure statement

None of the authors have any proprietary interests or conflict of interest related to this submission. https://ncdbapp.facs.org/puf/

Data availability statement

Data used in this study are from the American College of Surgeons Participant Use Data File, which is publicly available. https://ncdbapp.facs.org/puf/