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PubMed1995

The histologic grading of cancer.

BACKGROUND: The histologic grade of a tumor provides prognostic information in addition to that provided by stage of disease. Poorly differentiated tumors are known to pursue a more aggressive course than their well differentiated counterparts. METHODS: The frequency of grading and the relationship of grade to outcome was investigated for 793,649 cases of cancer from 15 anatomic sites as recorded in the Surveillance, Epidemiology, and End Results Program. RESULTS: For all cancers, the frequency of grading increased from 1973 to 1987 and varied by anatomic site and histologic type. Survival decreased with advancing grade, and within each stage, grading separated cases into at least three distinct prognostic subgroups. For some cancers, regional stage cases assigned Grade 1 or 2 had higher survival rates than did localized stage cases assigned Grade 3 or 4. Therefore, grading allowed the identification of high and low risk subgroups within each stage grouping. CONCLUSIONS: The tumor grade was a strong prognostic indicator for cancers of the urinary bladder, endometrium, and prostate--sites most often graded by pathologists. The histologic grade was also an important determinant of outcome for cancers of the brain, soft tissue, and breast; however, only a small percentage of these tumors were graded. The results are important because no common criteria for grading were established among the many contributing pathologists. Therefore, observer variation did not alter the known relationship of histologic grade to outcome. This review demonstrates that the histologic grade is a strong predictor of outcome that refines the prognostic information provided by the stage of disease.

Female↗
PubMed2006

Factors associated with patient involvement in surgical treatment decision making for breast cancer.

OBJECTIVE: To evaluate factors associated with women's reported level of involvement in breast cancer surgical treatment decision making, and the factors associated with the match between actual and preferred involvement in this decision. METHODS: Survey data from breast cancer patients in Detroit and Los Angeles was merged with surgeon data for an analytic dataset of 1101 patients and 277 surgeons. Decisional involvement and the match between actual and preferred amount of involvement were analyzed as three-level dependent variables using multinomial logistic regression controlling for clustering within surgeons. Independent variables included patient demographic and clinical factors, surgeon demographic and practice factors, cancer program designation, and two measures of patient-surgeon communication. RESULTS: We found variation in women's actual decisional involvement and match between actual and preferred involvement. Women with a surgeon-based or patient-based (versus shared) decision were significantly (p < or = 0.05) younger. Women who had too little decisional involvement (versus the right amount) were younger, while women with too much involvement had less education. Patient-surgeon communication variables were significantly associated with both involvement and match, and higher surgeon volume as associated with too little involvement. CONCLUSION: Patient factors and patient-surgeon communication influence women's perception of their involvement in breast cancer surgical treatment decision making. PRACTICE IMPLICATIONS: Decision tools are needed across surgeons and practice settings to elicit patients' preferences for involvement in treatment decisions for breast cancer.

Adult↗
PubMed1999

Prostate cancer histologic trends in the metropolitan Detroit area, 1982 to 1996.

OBJECTIVES: One of the concerns regarding the widespread use of serum prostate-specific antigen (PSA) as a screening tool for prostate cancer is the possibility that it may detect latent or clinically insignificant cancers. One indicator of clinical importance is thought to be histologic grade, with clinically unimportant cancers more likely to be well differentiated and clinically important tumors more likely to be moderately or poorly differentiated. METHODS: Data from the metropolitan Detroit population-based Surveillance, Epidemiology, and End Results Program were examined to determine trends in prostate cancer histologic grading before and after the introduction of PSA screening. RESULTS: From 1989 through 1996, the most recent year for which data are available, a dramatic increase in the incidence of prostate cancer occurred in the Detroit area, corresponding to the routine use of PSA as a screening test for prostate cancer. Local stage cancer demonstrated the largest increase in incidence. The incidence of moderately differentiated cancers also rose substantially during the same period; the incidence of poorly differentiated tumors remained about the same, and the incidence of well differentiated tumors decreased. Coincident with the increasing proportion of moderately differentiated cancers was a significant increase in the proportion of prostate biopsies performed (P = 0.001). CONCLUSIONS: These population-based data add important evidence that prostate cancers identified with PSA are more likely to be moderately than well differentiated. Additionally, if the definition of clinical significance depends on histopathologic grade, this finding could further be interpreted as evidence that PSA is more likely to detect clinically significant prostate cancer.

Adult↗
PubMed2001

Age-specific survival after Hodgkin's disease in a population-based cohort (United States).

OBJECTIVE: To examine risk factors for disease-specific survival in young and older adults diagnosed with Hodgkin's disease (HD) in a representative case series of adequate size for detecting effect modification by age group. METHODS: For 5630 young adults (ages 15-44) and 2424 older adults (ages 45 and older) diagnosed with HD and reported to the population-based Surveillance, Epidemiology, and End Results program of the National Cancer Institute between 1983 and 1995, Kaplan-Meier survival curves were constructed and Cox proportional hazards regression used to evaluate the influences of age, sex, race/ethnicity, histologic subtype, Ann Arbor stage at diagnosis, and calendar year on hazard of disease-specific death. RESULTS: The effects of most previously studied risk factors for HD death were different for young and older adults. Age was not associated with disease-specific survival in young adults, but in older adults, 1-year increases in age elevated the relative hazard of HD death by 4 6%. Male sex was related to outcome in young but not older adults, and Ann Arbor stage and B-symptom status exhibited markedly different relationships to survival by age. Older adult patients with and without B-symptoms had different hazards of mortality and had to be assessed separately. CONCLUSIONS: Factors associated with disease-specific survival were different for young and older adults with HD. These findings provide further support for two etiologically and clinically distinct disease entities.

Adolescent↗
PubMed2002

Global increases in kidney cancer incidence, 1973-1992.

Reports of increasing rates for kidney cancers in several count prompted this analysis of global incidence trends for total kidney cancers and by subsite. International incidence data for 5-year periods 1973-1977, 1978-1982, 1983-1987 and 1988-1992 were obtained from volumes IV to VII of Cancer Incidence in Five Continents published by the International Agency for Research on Cancer. The USA data for the same 5-year periods were obtained from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute. Percentage changes in incidence rates were computed using the relative difference between the time periods 1973-1977 and 1988-1992, and annual percentage changes in incidence rates were computed using log linear regression. In 1988-1992, kidney cancer incidence rates (age-adjusted to the world-standard population) were highest in France (16.1/100,000 man-years and 7.3/100,000 woman-years) and lowest in India (2.0 and 0.9, respectively). Between 1973-1977 and 1988-1992, incidence rates rose among men and women in all regions and ethnic groups, with a few exceptions, mostly in Scandinavian countries. The largest percentage increase for men was in Japan (171%) and for women in Italy (107%). Rates for renal pelvis cancer were less than 1/100,000 person-years in almost all regions in both sexes, and the temporal trends were inconsistent. Incidence trends for renal parenchyma cancer tracked those for total kidney cancers, and appeared to result from increases in the prevalence of risk factors and in use of diagnostic imaging procedures.

Americas↗
PubMed2003

Risk of mortality by histologic type of breast cancer among women aged 50 to 79 years.

BACKGROUND: Recent studies suggest that the use of combined estrogen and progestin hormone replacement therapy is associated with an increased risk of invasive lobular carcinoma (ILC), but that it has little association with risk of invasive ductal carcinoma (IDC). Also, the incidence rates of ILC have risen over the past 10 years while those of IDC have remained constant. Differences in survival rates by histologic types of tumor have been reported, but few of the published studies were population based or had adequate power to address this issue. METHODS: We conducted a retrospective cohort study spanning the years 1974 through 1998 using data from the 9 cancer registries that have participated in the Surveillance, Epidemiology, and End Results Program since 1974. The cohort consisted of 164 958 women aged 50 to 79 years who had been diagnosed as having 1 of 7 histologic types of invasive breast cancer. Risks of mortality due to any cause were estimated using the Cox proportional hazards model. RESULTS: Women with ILC had a risk of mortality 11% lower than women with IDC. The magnitude of this difference has increased over the past 10 years and, from 1994 through 1998, the risk of mortality was 26% lower for women with ILC. Also, the risk of mortality was between 8% and 34% lower in women with mucinous carcinoma, comedocarcinoma, or medullary, tubular, and papillary carcinomas compared with women with IDC. CONCLUSIONS: Differences in prognosis by histologic type of breast cancer were identified. The survival rate of women 50 to 79 years old who have ILC, the cancer whose histologic type is the most closely linked with the use of combined estrogen and progestin hormone replacement therapy, is more favorable than that of women with IDC and appears to be improving over time.

Adenocarcinoma, Mucinous↗
PubMed2002

Cancer incidence patterns among Vietnamese in the United States and Ha Noi, Vietnam.

Nearly 600,000 persons have immigrated to the United States from Vietnam since the end of the Vietnam War. Despite the rapid growth of the U.S. Vietnamese population, little is known about cancer incidence in this migrant group. Using population-based data from the Surveillance, Epidemiology and End Results program, California Cancer Registry and International Agency for Research on Cancer, we compared cancer incidence rates for Vietnamese in the United States (1988-1992) to rates for residents of Ha Noi, Vietnam (1991-1993); non-Hispanic whites were included to serve as the U.S. reference rates. Lung and breast cancers were the most common among Vietnamese males and females, respectively, regardless of geographic region. Rates of cancers more common to U.S. whites, such as breast, prostate and colon cancers, were elevated for U.S. Vietnamese compared to residents in Ha Noi but still lower than rates for U.S. whites. Rates of cancers more common to Asian countries, such as stomach, liver, lung and cervical cancers, were likewise elevated for U.S. Vietnamese compared to residents of Ha Noi and exceeded corresponding rates for whites. Incidence patterns for stomach, liver, lung and cervical cancers may reflect increased risk of exposures in this migrant population and should be further explored to uncover the relative contributions of environmental and genetic factors to cancer etiology.

Adolescent↗
PubMed2006

Incidence of primary urethral carcinoma in the United States.

OBJECTIVES: Primary urethral carcinoma is rare, and the demographic correlates of its incidence have not been examined using population-based data. METHODS: The National Cancer Institute Surveillance, Epidemiology, and End Results database was used to identify persons diagnosed with primary urethral carcinoma from 1973 to 2002. During this period, the Surveillance, Epidemiology, and End Results program included population-based tumor registries in nine geographic areas that represented approximately 10% of the U.S. population. The incidence rates were tabulated for the major histologic subtypes according to age, sex, and race. RESULTS: Primary urethral carcinoma was identified in 1075 men and 540 women, with an annual age-adjusted incidence rate of 4.3 per million and 1.5 per million, respectively. The annual incidence rate increased with age to a peak of 32 per million men and 9.5 per million women in the 75 to 84-year age group. The rate was 5.0 per million and 2.5 per million for African Americans and whites, respectively. The histologic types were transitional cell carcinoma in 888 patients (55%), squamous cell carcinoma in 348 (21.5%), and adenocarcinoma in 265 (16.4%). The incidence of the three primary histologic types varied by race and sex. CONCLUSIONS: In the United States, the incidence of urethral carcinoma is relatively higher in men and African Americans, with a histologic profile differing from that previously described.

Adenocarcinoma↗
PubMed1995

Cancer incidence in a group of workers potentially exposed to ethylene oxide.

BACKGROUND: Cytogenetic changes associated with ethylene oxide (ETO) exposure at a worksite prompted a study of cancer incidence in that cohort. METHOD: Cancer incidence through 31 December 1987 was ascertained in a cohort of 1132 individuals employed at the worksite at any time from 1 July 1974 through 30 September 1980, the period of potential exposure to ETO at the plant. The number of observed cancers was compared with that expected based on age- and sex-specific incidence rates reported by the National Cancer Institute's Surveillance Epidemiology and End Results Program. Standardized morbidity ratios (SMR) were calculated separately for regular and temporary employees. RESULTS: Of the 28 cancers observed in the cohort, 12 were breast cancers. The SMR for breast cancer among regular female employees ranged from 2.55 (95% CI: 1.31-4.98, P = 0.02) to 1.70 (95% CI: 0.89-3.23, P = 0.09) depending on calendar year of follow-up, assumptions about completeness of follow-up, and the reference rates used. The excess of breast cancer over expected in regular female employees diminished over time. No statistically significant excess of breast cancer was noted for temporary female employees at any point during follow-up. No increase in cancer incidence was found over that expected for any cancer sites associated with ETO in previous studies--leukaemia, brain, pancreas and stomach. CONCLUSIONS: Factors such as appropriateness of latency periods, length of follow-up and lack of a common histopathological type need to be considered in evaluating the excesses in observed breast cancer incidence, which diminished over time.

Adult↗
PubMed2005

What's new in the management of penile cancer?

PURPOSE OF REVIEW: Penile cancer is a rare disease. This has led to little in the way of therapeutic advances in the last two decades. Efforts have been made to minimize the use of disfiguring or morbid procedures in treating the primary tumor or managing the inguinal region. In addition, new insights have been gained into multimodal therapy for treating metastatic disease. We reviewed the literature published during the past two years to define the recent insights into the diagnosis and management of penile cancer. RECENT FINDINGS: Surveillance, Epidemiology and End Results Program data revealed poor outcome among African-American patients compared with Caucasians with penile cancer. Risk factors, including human papilloma virus, HIV, and the practice of circumcision have been reassessed. To improve diagnosis and staging, new modifications in imaging have been developed including magnetic resonance imaging with artificial erection. In addition, the technique of dynamic sentinel node biopsy has been refined. Pathologic features of the primary tumor (i.e., stage, grade, vascular invasion) assist in identifying patients who would benefit from lymphadenectomy. Organ-sparing treatments using laser ablation and reconstructive procedures to preserve glans or phallus length have also been developed. Systemic chemotherapy regimens, including consolidative approaches with surgery or radiotherapy, are discussed for advanced penile cancer. SUMMARY: Penile cancer remains a rare disease. Epidemiologic insights reveal provocative findings with respect to risk factors and racial differences in the outcome. Recent literature provides information that will aid urologists in (1) minimizing the need for disfiguring treatment of penile tumors in some patients and (2) reducing the number of unnecessary inguinal staging procedures in others. Novel systemic therapies that generate durable responses tested in multi-institutional treatment trials are needed.

Combined Modality Therapy↗
PubMed1998

Breast cancer histology in Caucasians, African Americans, Hispanics, Asians, and Pacific Islanders.

STUDY OBJECTIVES: To investigate the association between race/ethnicity and histologic types of breast cancer. DESIGN: Cross-sectional study. SETTING: Population-based data from the Northern California Tumor Registry, which is part of the National Cancer Institute's Surveillance, Epidemiology and End Results Program. PARTICIPANTS: A total of 2759 breast cancer cases diagnosed in 1988. MAIN RESULTS: Tumors were classified as ductal, lobular, and mixed/unspecified carcinoma. Ductal carcinoma was the most common (83.6%) and lobular carcinoma was the rarest. Most cases were diagnosed in the localized stage (56.3%). Caucasian women had the highest rates of total breast cancer (240.9/100,000), ductal and lobular. In African-American women, the odds of ductal carcinoma were twice that of lobular carcinoma, compared with Caucasian women (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.0-3.9) after adjusting for age, site, and stage at diagnosis. Similarly, Asian and Hispanic women also had higher, non-statistically significant odds of ductal versus lobular carcinoma compared with Caucasians (OR = 1.8 [95% CI 0.9-3.7] and 1.6 [95% CI 0.8-3.4], respectively). CONCLUSIONS: Future studies should investigate how racial/ethnic differences in histology among breast cancer patients will influence life expectancy, against a backdrop of health care access, sociocultural issues, lifestyle habits, reproductive history, family history, and tumor characteristics.

Adult↗
PubMed2004

Updated population-based review of carcinoid tumors.

OBJECTIVE: To determine the population-based incidence, anatomic distribution, and survival rates of gastrointestinal carcinoid tumors. BACKGROUND: Carcinoid tumors arise from neuroendocrine cells and may develop in almost any organ. Many textbooks and articles represent single institution studies and report varying incidence rates, anatomic distribution of tumors, and patient survival rates. Population-based statistics remain largely unknown. METHODS: Data was obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results program (1973 to 1997). Incidence rates, distribution, and 5-year survival rates were analyzed. Multivariate Cox regression was used to identify predictors of survival using age, race/ethnicity, gender, and tumor characteristics (size, lymph node status, and stage). RESULTS: Of the 11,427 cases analyzed, the average age was 60.9 years, and 54.2% were female. The overall incidence rates for carcinoid tumors have increased significantly over the past 25 years, although rates for some sites have decreased (eg, appendix). The gastrointestinal tract accounted for 54.5% of the tumors. Within the gastrointestinal tract, the small intestine was the most common site (44.7%), followed by the rectum (19.6%), appendix (16.7%), colon (10.6%), and stomach (7.2%). The 5-year survival rates for the most common gastrointestinal sites were stomach (75.1%), small intestine (76.1%), appendix (76.3%), and rectum (87.5%). CONCLUSIONS: Using national, population-based cancer registry data, this study demonstrates that (1) incidence rates for carcinoid tumors have changed, (2) the most common gastrointestinal site is not the appendix (as is often quoted), but the small intestine, followed in frequency by the rectum, and (3) survival rates differ between individual anatomic sites.

Carcinoid Tumor↗
PubMed2005

Differences in survival by histologic type of pancreatic cancer.

OBJECTIVE: Although pancreatic cancer has an extremely high case fatality rate, little is known about differences in mortality by histologic types. We examined median survival and risk of mortality for endocrine pancreatic tumors and two types of exocrine tumors, adenocarcinomas, and mucinous tumors. METHOD: This analysis included 35,276 pancreatic cancer cases reported to the nine population-based cancer registries participating in the Surveillance, Epidemiology, and End Results program from 1973 to 2000. Survival among cases with pancreatic adenocarcinomas, mucinous tumors, and endocrine tumors were compared using Kaplan-Meier plots. Comparative risks of mortality were evaluated using multivariate adjusted Cox regression models. RESULTS: Endocrine pancreatic cancer cases had a median survival of 27 months compared with a median survival of 4 months for adenocarcinoma and mucinous tumor cases. Compared with adenocarcinoma cases, endocrine tumor cases had a 0.28-fold lower risk of mortality [95% confidence interval (95% CI), 0.26-0.30], and mucinous tumor cases had a 0.88-fold lower risk (95% CI, 0.84-0.91). These results were similar for men and women. Within histologic types, advanced tumor stage, older diagnosis age, surgery, and Black race were associated with increased risks of mortality, whereas female sex and more recent year of diagnosis were associated with decreased risks. CONCLUSION: This study confirms the clinical observation that patients with endocrine pancreatic cancer survive longer than patients with exocrine tumors. A better understanding of these differences could contribute to identifying the underlying causes of pancreatic cancer and to improving survival rates across all histologic types.

Adenocarcinoma, Mucinous↗
PubMed2003

Inflammatory breast carcinoma and noninflammatory locally advanced breast carcinoma: distinct clinicopathologic entities?

PURPOSE: Inflammatory breast carcinoma (IBC) and noninflammatory locally advanced breast carcinoma (LABC) are both associated with poor prognosis; however, whether they are distinct clinicopathologic entities remains controversial. MATERIALS AND METHODS: To determine whether IBC and LABC were different, we compared tumor characteristics, prognosis, and age-specific incidence rate patterns in the Surveillance, Epidemiology, and End-Results program. An age of 50 years served as a surrogate marker for menopause. RESULTS: Younger age at diagnosis, poorer tumor grade, and negative estrogen receptors (ERs) were more predictive of IBC (n = 2,237) than of LABC (n = 7,985). Breast carcinoma survival was worse for patients with IBC than for those with LABC (log-rank test, P <.0001). Age-specific incidence rates for IBC increased until 50 years and then flattened, whereas rates for LABC increased for all ages. When rates for LABC were stratified by estrogen receptor-positive (ERP) and -negative (ERN) expression, rates for ERP and ERN diverged; that is, rates for ERP increased with advancing age, whereas rates for ERN flattened after 50 years. When rates for IBC were stratified by ER expression, rates for both ERP and ERN flattened after 50 years of age. CONCLUSION: IBC and LABC seemed to be distinct biologic entities, as indicated by different prognostic factor profiles and age-specific incidence rate patterns. Rates that increased before 50 years and then stabilized, possibly indicated that premenopausal exposures had a greater effect on maintaining rates for IBC than for LABC.

Adult↗
PubMed1995

Colorectal cancer in patients with esophageal adenocarcinoma.

The incidence of adenocarcinoma of the esophagus and gastric cardia has been rising rapidly in Western Europe and the United States, especially among white males. Previous reports, based on case series, have suggested an association between colonic neoplasia and Barrett's esophagus, a metaplastic condition of the lower esophagus that can lead to adenocarcinoma. We analyzed cancer incidence data from 1973 to 1989 from the nine population-based registries of the Surveillance, Epidemiology, and End Results program of the United States National Cancer Institute to investigate this association, using malignancies as an outcome. Using a case-control design, we measured the odds of being diagnosed with colorectal adenocarcinoma some time in life among persons diagnosed with adenocarcinomas of the esophagus or gastric cardia relative to persons diagnosed with squamous cell carcinomas of the esophagus. Among white males the odds ratio was 1.44 (95% confidence interval, 1.03-2.02). This association appeared to be independent of which cancer occurred first. In contrast, white females with adenocarcinomas were less likely to be diagnosed with colorectal cancer than those with squamous cell carcinomas (odds ratio, 0.39; 95% confidence interval, 0.19-0.78). These associations appeared to be specific for colorectal tissue because there was no relationship between histological type of esophageal cancer and prostate cancer in men or breast cancer in women. We conclude that men with esophageal adenocarcinoma may be more likely to be diagnosed with colorectal cancer in their lifetime than expected; the opposite association may exist for women.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1999

Role of transurethral resection of the prostate in population-based prostate cancer incidence rates.

The extensive pool of asymptomatic prostate disease in the population, which increases substantially with age, suggests that the frequent use of transurethral resection of the prostate (TURP) in recent decades has had a large effect on prostate cancer incidence. The authors identified the effect of TURP-detected prostate cancer on the observed incidence rates between 1973 and 1993 for men aged 65 years and older. They linked population-based cancer registry data from the Surveillance, Epidemiology, and End Results Program to Medicare records between 1986 and 1993 to determine whether a TURP occurred sufficiently close to the time of a prostate cancer diagnosis for them to assume that it led to the diagnosis. TURP-detected cases prior to 1986 were calculated using an indirect method that involved multiplying the TURP procedure rate in the general population (from the National Hospital Discharge Survey) by estimates of the proportion of TURPs resulting in a prostate cancer diagnosis (from Medicare data and the literature). TURP explained much of the observed increase in overall prostate cancer incidence between 1973 and 1986 and possibly all of it in men aged 70 years and older. However, its influence on the trend and overall magnitude of the rates diminished between 1987 and 1993. The changing role of TURP in detecting prostate cancer is attributed to changes in medical technology and screening practices. The declining influence of TURP on prostate cancer incidence is likely to have continued beyond the study period due to the recent introduction and increasing use of medications for treating obstructive uropathy.

Aged↗
PubMed2006

Ovarian cancer in younger vs older women: a population-based analysis.

To compare the clinico-pathologic prognostic factors and survival of younger vs older women diagnosed with epithelial ovarian cancer. Demographic, clinico-pathologic, treatment, and surgery information were obtained from patients with ovarian cancer from the Surveillance, Epidemiology, and End Results Program from 1988 to 2001 and analysed using Kaplan-Meier estimates. Of 28 165 patients, 400 were <30 years (very young), 11 601 were 30-60 (young), and 16 164 were >60 (older) years of age. Of the very young, young, and older patients, 261 (65.3%), 4664 (40.2%), and 3643 (22.5%) had stage I-II disease, respectively (P<0.001). Across all stages, very young women had a significant survival advantage over the young and older groups with 5-year disease-specific survival estimates at 78.8% vs 58.8 and 35.3%, respectively (P<0.001). This survival difference between the age groups persists even after adjusting for race, stage, grade, and surgical treatment. Reproductive age (16-40 years) women with stage I-II epithelial ovarian cancer who received uterine-sparing procedures had similar survivals compared to those who underwent standard surgery (93.3% vs 91.5%, P=0.26). Younger women with epithelial ovarian cancer have a survival advantage compared to older patients.

Adenocarcinoma, Clear Cell↗
PubMed2005

Population-based incidence of uveal melanoma in various races and ethnic groups.

PURPOSE: To investigate racial/ethnic differences in the development of uveal malignant melanoma in a large population-based study. DESIGN: Observational cross-sectional study. METHODS: With the 1992 to 2000 data that was provided by the National Cancer Institute's Surveillance, Epidemiology, and End Results Program, we calculated age-adjusted incidence rates of uveal melanoma in various racial/ethnic groups (black, Asian and Pacific Islander, Hispanic, and non-Hispanic white). In addition, we calculated the standard incidence ratio (risk ratio) and 95% confidence interval to describe the differences within these racial/ethnic groups. RESULTS: From 1992 to 2000, there were a total of 1352 uveal melanomas that were diagnosed in 11 Surveillance, Epidemiology, and End Results registries with known racial/ethnic groups. The annual age-adjusted incidence (per million population) of uveal melanoma was 0.31 (black), 0.38 (Asian), 1.67 (Hispanic), and 6.02 (non-Hispanic white). The difference in the incidence of uveal melanoma between each racial/ethnic group was highly statistically significant, with the exception of the black versus the Asian population in which there was no statistically significant difference. CONCLUSION: The relative risk of uveal melanoma was 1.2 for Asian and Pacific Islander patients, 5.4 for Hispanic patients, and 19.2 for non-Hispanic white patients as compared with the black patients. If the non-Hispanic white population and the Hispanic population were combined, then the overall white:black ratio was 18:1.

Cross-Sectional Studies↗