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Racial and Ethnic Health Disparities"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Black patients with cancer experience worse relative survival, yet it remains unclear how far shifting diagnoses towards earlier stage would reduce mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed Surveillance, Epidemiology, and End Results (SEER) data (2004\u20132022) for U.S. Black and White patients aged 15\u201389 years with eight common cancers, using a 2021\u20132022 period-analysis window. We estimated age-standardised survival under observed and counterfactual stage distributions in which Black patients had the White stage distribution. We quantified the proportion of the racial survival gap mediated by stage and deaths postponed beyond specified follow-up times.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,299,386 eligible patients, Black patients were diagnosed at similar or younger ages and had more distant-stage disease for most sites, except rectal cancer in Black women aged\u2009&lt;\u200975 years. At 5 years, stage accounted for large shares of the Black-White disparity in breast, colon, corpus uteri, lung, and oral cavity and pharynx cancers. The mediated proportion was low for rectal cancer in men, pancreatic cancer, and ovarian cancer, with weak evidence for ovarian cancer at age 75\u2009+\u2009years and pancreatic cancer in women. The negative indirect effect for rectal cancer in younger women indicated suppression. Deaths postponed varied by follow-up time and cohort size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stage equalisation could yield meaningful short-term mortality reductions for several sites, but stage-focused strategies are not universally beneficial. Equity-oriented policies should pair earlier diagnosis with interventions to improve downstream care pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s40615-026-03197-3","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:33:07Z","timestamp":1792420387000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying the Role of Stage-at-Diagnosis in Racial Disparities in US Cancer Survival: A Population-Based SEER Study for 8 Common Cancers"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2093-8117","authenticated-orcid":false,"given":"Aisha","family":"Vayani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1557-6697","authenticated-orcid":false,"given":"Mark","family":"Rutherford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1799-3144","authenticated-orcid":false,"given":"Sarah","family":"Booth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"issue":"2","key":"3197_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.3322\/caac.21874","volume":"75","author":"AH Saka","year":"2025","unstructured":"Saka AH, Giaquinto AN, McCullough LE, Tossas KY, Star J, Jemal A, et al. 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No directly identifiable information was used. Institutional ethical approval and individual informed consent were not required for this secondary analysis of de-identified registry data.","order":1,"name":"Ethics","label":"Ethical Approval and Consent to Participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Sarah Booth is employed by Aviva for work unrelated to this research. The remaining authors declare that they have no competing interests.","order":2,"name":"Ethics","label":"Competing Interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}