Study reports racial, ethnic differences in young people with cancer ~ hiv virus

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August 23, 2013

Mei-Chin Hsieh, MSPH, CTR, of LSU Health Sciences Center New Orleans School of Public Health's Louisiana Tumor Registry, is the lead author of a study that reports racial and ethnic differences in the incidence of soft tissue sarcomas in adolescents and young adults. The research, conducted at LSU Health Sciences Center New Orleans School of Public Health, is published online in the Journal of Adolescent and Young Adult Oncology.

The LSUHSC research team, which also included Xiao-Cheng Wu, MD, MPH, Director of the LSUHSC Louisiana Tumor Registry, Patricia Andrews, MPH, Instructor of Epidemiology, and Vivien Chen, PhD, Professor of Epidemiology, analyzed 1995-2008 incidence data from 25 population-based cancer registries covering 64% of the United States population, which they obtained from the North American Association of Central Cancer Registries.

The incidence rates of soft tissue sarcoma types in cancer patients who are 15 to 29 years old vary among racial/ethnic groups. The incidence of all soft tissue sarcomas combined was 34% higher in males than females, 60% higher among African-Americans than Caucasians, and slightly higher among Hispanics than Caucasians. The researchers found that African-American and Hispanic males had a higher incidence of Kaposi sarcoma than Caucasians. For non-Kaposi sarcoma, African-Americans had a significantly higher incidence of fibromatous tumors and rhabdomyosarcoma than Caucasians, Hispanics had a significantly higher incidence of liposarcoma, and Caucasians were more likely to be diagnosed with synovial sarcoma than African-Americans.

"Most studies on adolescents and young adults aged 15 to 29 have focused on the comparison of this age group with younger and/or older populations with less focus on quantifying the differences among racial/ethnic groups within this age group," notes Hsieh. The National Cancer Institute defines soft tissue sarcoma as a cancer that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. There are a number of different types. They include Kaposi sarcoma, a malignancy that occurs in blood vessel walls that often affects people with immune deficiencies, such as HIV/AIDS; fibrosarcoma – tumors in fibrous tissue in the arms, legs, or trunk; liposarcoma – tumors in fatty tissue, often in the legs and trunk; rhabdomyosarcoma – cancer that occurs in skeletal muscle; and synovial sarcoma – cancer in the tissue around the joints and ankles.

This type of research provides information that can improve care. It raises awareness of the need for inclusion of cancer patients in this age group in clinical trials. It alerts physicians to the racial/ethnic disparities for different cancers. It can also direct policy. For instance, policies could be implemented to prevent Kaposi sarcoma since it is the only type among all soft tissue sarcomas that is amenable to prevention through appropriate interventions. Further efforts should focus on developing effective racially and ethnically sensitive and culturally acceptable interventions in order to minimize the disparities and ultimately reduce the incidence of Kaposi sarcoma in young adults of all races/ethnicities.

While disparities are also observed for common non-Kaposi sarcoma types, no well-established cancer controls are currently in place. Unlike Kaposi sarcoma, factors for racial and ethnic disparities in non-Kaposi sarcoma incidence among adolescents and young adults are less clear. More research on factors contributing to the racial and ethnic disparities of non-Kaposi sarcomas is needed.

"We hope that, based on our study results, more attention will be paid to all aspects of cancer care for this age group," Hsieh concludes. The research is a special study of the LSU Health Sciences Center New Orleans School of Public Health's Louisiana Tumor Registry, which is one of the 18 competitively awarded cancer registries in the SEER (Surveillance, Epidemiology and End Results) Program of the National Cancer Institute. The SEER Program is the most authoritative source of information on cancer incidence and survival in the United States. LSUHSC's Louisiana Tumor Registry is also a member of the North American Association of Central Cancer Registries.

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More information: online.liebertpub.com/doi/abs/10.1089/jayao.2012.0031