Abstract
Abstract only
e13086
Background: To investigate racial and epidemiological disparities in presentation and prognosis of conjunctival cancer in a retrospective population-based study. Methods: Non-Hispanic white (NHW) and African American patients with squamous cell carcinoma or melanoma of the conjunctiva or cornea with known age, insurance, gender, zip code-level income and education, and tumor size were selected from the National Cancer Database (NCDB). Patients were stratified based on race and ethnicity into two mutually exclusive groups, and unadjusted comparisons were made with the Chi-square or Mann-Whitney tests. Survival was examined with the Kaplan-Meier method and a Cox regression model was employed after checking that the proportional hazards assumption was met for all pertinent variables. SAS version 9.4 was used for all analyses and p< 0.05 was considered significant. Results: Of the 2,192 identified patients from 2004 to 2014, 104 were African American. Unadjusted differences were found between groups in regard to age, histology, insurance, income, and education. African American patients in comparison to NHW were younger (median age: 61 years vs. 71 years; p< 0.001), had a higher proportion of Medicaid (10.6% vs. 3.4%) or no insurance (11.5% vs. 2.7%), and resided in areas with lower levels of education (36.5% of African American patients vs. 17.0% of NHW patients were from areas with greater than 21% of the population with no high school degree). It was also found that African Americans had higher proportion of squamous cell carcinoma than NHW (69.9% vs. 81.7%; p= 0.007). In general, risk of death was higher for older African American males with no private insurance, and for those from areas of lowest level of income. Conclusions: Disparities in socioeconomic factors were observed in the African American population. In addition, the overall incidence of conjunctival and corneal cancer occurs at a younger age in African Americans, who also face poorer prognoses. This association between social inequality and poor outcome warrant further investigation.