Racial/ethnic disparity relating to treatment selection and clinical outcomes is of concern in the field of oncology. Cutaneous lymphoma represents a relatively rare oncologic disorder for which mycosis fungoides is the most common subtype. This disorder has been well documented as having a higher incidence in African Americans than whites, but based on relatively small retrospective series, the use of radiotherapy (which is the most effective treatment for the disorder) appears to be relatively underutilized in African American patients compared with whites. The objective of the proposed research project, using the NIH SEER population based registry, is to evaluate the use of radiotherapy, analyze various clinical parameters, and document clinical outcomes for these patients by racial group utilizing multivariable analysis. The method which will be utilized to support the current research is analysis of epidemiologic, therapeutic and outcomes data to the degree that they are available within the SEER database. Radiotherapy will be specifically evaluated with respect to its incorporation in therapeutic management of patients with cutaneous lymphoma for various racial groups but with specific attention to its incorporation in the management of African Americans versus whites. The SEER database provides information regarding incidence and epidemiologic factors, clinical outcomes relating to survival, and utilization of radiotherapy. The statistical analysis will be sufficiently powered to provide adequate control for potential confounding variables. Findings will be used as preliminary data to support a more extensive research project which would incorporate SEER Medicare data. Through the use of the SEER Medicare data set, additional information regarding details of radiotherapy, provider referral patterns, potential healthcare referral disparity, cost analysis, and access to care would be documented for those suffering from cutaneous lymphoma. These findings would potentially lead to new educational initiatives for medical professionals, change in clinical policy, and identification of special awareness regarding disparities in medical decision making and access to care.
The relevance of the proposed project regarding racial disparity in the therapeutic use of radiotherapy for patients with cutaneous lymphoma is potentially significant. Documentation of such disparities is highly relevant as this would provide objective evidence to support revised medical education on the topic of cutaneous lymphoma, increased awareness of issues related to disparity, and potential change in therapeutic decision making for those patients affected by the disorder.
| Nath, Sameer K; Yu, James B; Wilson, Lynn D (2014) Poorer prognosis of African-American patients with mycosis fungoides: an analysis of the SEER dataset, 1988 to 2008. Clin Lymphoma Myeloma Leuk 14:419-23 |
| Wilson, Lynn D; Hinds, Ginette A; Yu, James B (2012) Age, race, sex, stage, and incidence of cutaneous lymphoma. Clin Lymphoma Myeloma Leuk 12:291-6 |
