{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:35:48Z","timestamp":1791416148861,"version":"4.3.3"},"reference-count":66,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240930-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>There are limited studies assessing stage at diagnosis and risk of death among all 5 federally defined races in the US among adolescent and young adult (AYA) patients with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi240930-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify racial disparities in stage at diagnosis and survival among AYA patients with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi240930-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study used data from a US national hospital-based oncology database on AYA patients, aged 15 to 39 years, with the 10 deadliest cancers among AYA patients who received a diagnosis from January 1, 2004, to December 31, 2017, with 6 months or more of follow-up. Analyses by race were categorized by the 5 federally defined races in the US: American Indian or Alaska Native, Asian, Black, Native Hawaiian or Other Pacific Islander, and non-Hispanic White (hereafter,\n                      <jats:italic>White<\/jats:italic>\n                      ). White patients served as the majority reference group. Statistical analysis was performed from November 2022 to September 2023.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi240930-7\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary end points were late stage at diagnosis (logistic regression with adjusted odds ratios [AORs] and 95% CIs) and overall survival (log-rank tests and Cox proportional hazards regression with adjusted hazard ratios [AHRs] and 95% CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi240930-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 291\u202f899 AYA patients (median age, 33 years [IQR, 28-37 years]; 186\u202f549 female patients [64%]; 189\u202f812 [65%] with stage I or II cancers) were evaluated. The cohort included 1457 American Indian or Alaska Native patients (1%), 8412 Asian patients (3%), 40\u202f851 Black patients (14%), 987 Native Hawaiian or Other Pacific Islander patients (0.3%), and 240\u202f192 White patients (82%). Cancers included breast (n\u2009=\u200979\u202f195 [27%]), lymphoma (n\u2009=\u200945\u202f500 [16%]), melanoma (n\u2009=\u200936\u202f724 [13%]), testis (n\u2009=\u200931\u202f413 [11%]), central nervous system (n\u2009=\u200926\u202f070 [9%]), colon or rectum (n\u2009=\u200922\u202f545 [8%]), cervix (n\u2009=\u200920\u202f923 [7%]), sarcoma (n\u2009=\u200914\u202f951 [5%]), ovary (n\u2009=\u20098982 [3%]), and lung (n\u2009=\u20095596 [2%]). Risk of late-stage diagnosis was higher for Asian (AOR, 1.20; 95% CI, 1.14-1.26), Black (AOR, 1.40; 95% CI, 1.36-1.43), and Native Hawaiian or Other Pacific Islander (AOR, 1.34; 95% CI, 1.16-1.55) patients compared with White patients. Overall survival differed by race for all cancer sites, except cancers of the central nervous system and ovary. Risk of death was higher for American Indian or Alaska Native (AHR, 1.15; 95% CI, 1.02-1.30), Black (AHR, 1.22; 95% CI, 1.19-1.26), and Native Hawaiian or Other Pacific Islander (AHR, 1.25; 95% CI, 1.09-1.44) patients but lower for Asian patients (AHR, 0.90; 95% CI, 0.85-0.95) compared with White patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi240930-9\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cohort study of AYA patients suggests that stage at diagnosis and survival varied across races for the 10 deadliest AYA cancers. These results support the need for tailored interventions and informed public policy to achieve cancer care equity for all races.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.30975","type":"journal-article","created":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T11:31:31Z","timestamp":1725017491000},"page":"e2430975","source":"Crossref","is-referenced-by-count":29,"title":["Racial Disparities in Cancer Stage at Diagnosis and Survival for Adolescents and Young Adults"],"prefix":"10.1001","volume":"7","author":[{"given":"Kekoa","family":"Taparra","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Stanford Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaeo","family":"Kekumano","sequence":"additional","affiliation":[{"name":"Department of Stem Cell and Regenerative Biology, Harvard College, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Benavente","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Roberto","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, UC Davis Medical Center, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Gimmen","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Shontell","sequence":"additional","affiliation":[{"name":"Department of Native Hawaiian Health, University of Hawai\u02bbi John A. 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California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtiland","family":"Deville","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaimie Z.","family":"Shing","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline B.","family":"Vo","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Branch, Division of Cancer Epidemiology, National Cancer Institute, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manali I.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Oncology, Stanford Medicine, Stanford, 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