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Br J Cancer. 2019 Apr;120(8):861-863. doi: 10.1038/s41416-019-0416-7. Epub 2019 Mar 20.

Serious adverse events in African-American cancer patients with sickle cell trait and inherited haemoglobinopathies in a SEER-Medicare claims cohort.

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Department of Internal Medicine, Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale University School of Medicine, New Haven, CT, USA.
New England Sickle Cell Institute, Division of Hematology/Oncology, Neag Comprehensive Cancer Center, UConn Health, Farmington, CT, USA.
Center for Quantitative Medicine, UConn School of Medicine, Farmington, CT, USA.
Department of Community Medicine and Health Care, UConn School of Medicine, Farmington, CT, USA.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
Department of Hematology-Oncology, St. Francis Hospital and Medical Center, Hartford, CT, USA.
Hartford Health Care Cancer Institute, Hartford Hospital, Hartford, CT, USA.
Department of Community Medicine and Health Care, UConn School of Medicine, Farmington, CT, USA.


African-American (AA) cancer patients have long-experienced worse outcomes compared to non-Hispanic whites (NHW). No studies to date have evaluated the prognostic impact of sickle cell trait (SCT) and other inherited haemoglobinopathies, of which several are disproportionately high in the AA population. In a cohort analysis of treated patients diagnosed with breast or prostate cancer in the linked SEER-Medicare database, the relative risk (RR) for ≥1 serious adverse events (AEs), defined as hospitalisations or emergency department visits, was estimated for 371 AA patients with a haemoglobinopathy (AA+) compared to patients without haemoglobinopathies (17,303 AA-; 144,863 NHW-). AA+ patients had significantly increased risk for ≥1 AEs compared to AA- (RR = 1.19; 95% CI 1.11-1.27) and NHW- (RR = 1.23; 95% CI 1.15-1.31) patients. The magnitude of effect was similar by cancer type, and in analyses of AA+ with SCT only. Our findings suggest a novel hypothesis for disparities in cancer outcomes.


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