Kate S. Woods

Background/Objectives: Solitary plasmacytoma of bone (SPB) results from abnormal proliferation of plasma cells and accounts for 2–5% of all plasmacytic malignancies. Radiation therapy is the standard of care in treating SPB due to its efficacy in controlling disease progression and optimizing patient survival. However, prior studies have highlighted disparities in radiation therapy receipt among various cancer types. In this study, we aim to investigate whether similar sociodemographic and clinical disparities exist in the treatment of SPB through use of the Surveillance, Epidemiology, and End Results (SEER) database. Methods: The SEER database was queried for biopsy-confirmed cases of SPB between 2000 and 2021 using the ICD-O-3 histology code 9731/3 and primary site codes C40.0–41.9. Chi-square tests, Fisher’s exact tests, and multivariable logistic regression were completed using SPSS v29.0.2, with significance set to p < 0.05. Results: A total of 4139 patients were identified, of which 75.3% received treatment with radiation therapy. Multivariable analysis revealed that low-income patients making less than $74,999 annually (aOR 0.80, 95% CI 0.67–0.97), as well as those from non-Hispanic Asian/Pacific Islander (aOR 0.49, 95% CI 0.33–0.73) and Hispanic (aOR 0.77, 95% CI 0.60–0.98) racial and ethnic groups, were significantly less likely to receive radiation therapy. Conclusions: These findings reveal notable disparities in radiation therapy utilization for SPB patients based on income and race and ethnicity, emphasizing the need for interventions to address systemic inequities, improve access to care, and ensure that all patients receive high-quality cancer care to optimize long-term outcomes.

Introduction: Time to initiation of therapy in oncological care is an influential factor in disease progression and survival outcomes in many cancer types. We aim to identify factors associated with delayed time to treatment (TTT) in high‐grade osteosarcoma and its relationship to disease‐specific survival (DSS). Methods: The SEER database was queried for biopsy‐confirmed cases of high‐grade osteosarcoma between 2000 and 2021 using ICD‐O‐3 histology codes 9180/3–9194/3 and primary site codes C40.0–41.9. χ ² , Kaplan–Meier with log‐rank testing, and stepwise multivariable logistic regression were completed using SPSS, with significance set to p < 0.05. Results: Kaplan–Meier analysis demonstrated significantly reduced 5‐ and 10‐year DSS in patients with TTT over 1 month ( p < 0.001). Multivariable analysis identified advanced age groups and tumors of the cranium (aOR 2.48; 95% CI 1.96–3.13), thorax (aOR 1.72; 95% CI 1.13–2.61), and pelvis (aOR 1.71; 95% CI 1.31–2.23) as factors associated with TTT delays over 1 month. Black race and Hispanic ethnicity were also significantly associated with treatment delays in subset analysis of patients < 40 years (aOR 1.74; 95% CI 1.27–2.39 and aOR 1.31; 95% CI 1.01–1.70). Conclusion: These findings reveal disparities in TTT for osteosarcoma patients based on age, race/ethnicity, and tumor location, highlighting the need for equitable access to early care.

Background: Lung cancer is the most frequent cause of cancer-related deaths in the United States and worldwide. Infectious diseases such as pneumonia and influenza are major risk factors for morbidity and mortality in patients diagnosed with lung cancer. Our study expands upon existing literature investigating epidemiological differences in lung cancer mortality, using the Centers for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiology Research (WONDER) database to report on influenza- and pneumonia-related mortality rates in lung cancer patients through multiple decades. Methods: CDC WONDER was used to identify influenza- and pneumonia-related deaths in lung cancer patients that occurred within the United States from 1999 to 2022. Crude and age-adjusted mortality rates (AAMR) were calculated, as well as annual percent change and weighted average annual percent change with 95% confidence intervals for the AAMRs. The Joinpoint Regression Program was used to determine trends in mortality within the study period. Results: From 1999 to 2022, male lung cancer patients demonstrated greater mortality rates from pneumonia and influenza compared to females (60.6% vs. 39.4%). When stratified by race and ethnicity, Black patients had the highest AAMR over the study period at 9.1 per 100,000 people in 1999, as well as the most significant reduction in AAMR to 4.9 per 100,000 people in 2022. Additionally, AAMRs were consistently higher in rural areas compared to urban locations. By age group, patients aged 75–84 had the highest overall crude mortality rate at 28.3 per 100,000 people in 1999, with the lowest rate in ages 35–44 at 0.2 per 100,000 people in 2022. Conclusion: This study expands upon previously reported trends in lung cancer mortality, highlighting epidemiological differences in influenza- and pneumonia-related death. Significant disparities in mortality rates were noted in older-aged, male, Black, and rural lung cancer patients. Targeted public health strategies concerning the unique needs of these diverse populations will be essential in improving mortality rates. Future research should also investigate the underlying causes of these disparities, and examine how certain community-based initiatives, such as campaigns for tobacco cessation, vaccination, and lung cancer screening, can inform guidelines and reduce preventable mortality in high-risk groups.

Background: Endometrioid ovarian carcinoma is a subtype of epithelial ovarian carcinoma and is the second most common type of malignant ovarian neoplasm. Studies investigating delayed treatment of ovarian cancer have identified significant impacts on overall survival rates. This study utilizes the Surveillance, Epidemiology, and End Results (SEER) database to identify cases of endometrioid ovarian carcinomas and factors associated with delays in time to treatment (TTT) greater than one month. Methods: The SEER database was queried to identify females with biopsy-confirmed cases of ovarian endometrioid carcinoma from 2010 to 2015. Chi-square tests, two-sided Fisher’s exact tests, and multivariable binary logistic regressions were completed using SPSS version 29.0.2. Statistical significance was confirmed when p < 0.05. Results: A total of 11,235 relevant patients were identified within the SEER database. A majority were Non-Hispanic White (69.2%), aged 50–59 (30.1%), had an annual income of $75,000+ (58.9%), resided in urban communities (90.0%), and were diagnosed with AJCC stage 1 disease (62.0%). When investigating treatment, 94.9% of patients received treatment within 1 month of diagnosis, while 5.1% experienced a delay of over 1 month before starting treatment. Multivariable binary logistic regression analysis demonstrated that American Indian and Alaksa Native (AIAN) patients independently experienced a +376% increased likelihood of treatment delays exceeding 1 month (aOR 4.76; 95% CI 1.32–17.08; p = 0.017). Patients diagnosed at AJCC stage III (aOR 1.88; 95% CI: 1.22–2.91; p = 0.004) or stage IV (aOR: 4.50; 95% CI: 2.75–7.38; p < 0.001) additionally had +88% and +350% higher odds of treatment delays greater than 1 month, respectively. Conclusions: AIAN patients and those presenting with later stage disease for endometrioid ovarian carcinoma face significantly longer TTT, indicating disparities in timely care. Our findings demonstrate an urgent need for targeted interventions to address systemic barriers contributing to delayed treatment in these populations.

Osteosarcoma is the most common primary malignancy of bone. Previous studies have demonstrated rural-urban disparities in metastatic disease incidence and overall survival in high-grade osteosarcoma patients. However, there is a paucity of literature investigating disease-specific survival (DSS) disparities between rural and urban patients, which is explored herein using the SEER database. Patients with biopsy-proven cases of osteosarcoma were identified from 2000–2021. Statistical analysis was completed using SPSS version 29.0.2 and included chi-squared, Kaplan–Meier and log-rank, and stepwise Cox regressions. Statistical significance was considered at p < 0.05. Kaplan–Meier analysis revealed no significant differences in 5- and 10-year DSS between rural (55.0% and 47.0%) and urban patients (56.0% and 51.0%) (p = 0.107). Multivariable analysis further revealed no significant DSS difference between rural and urban patients (aHR: 1.03; 95% CI: 0.86–1.24; p = 0.757). This study expands upon prior research by investigating DSS between rural and urban osteosarcoma patients and finding no significant differences. While rural living is often associated with worse outcomes, important prognostic factors for osteosarcoma, including metastatic disease at presentation and tumor grade, were not significantly different between rural and urban patients in our study, possibly explaining our DSS-related findings. Factors other than geographical location likely impact outcomes, and future research should examine other ways that rural living may influence cancer care.