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Deaths after Cancer Surgery higher in blacks (probably low vitamin D) – Dec 2020

Changes in Racial Disparities in Mortality After Cancer Surgery in the US, 2007-2016

JAMA Netw Open. 2020;3(12):e2027415. doi:10.1001/jamanetworkopen.2020.27415
Miranda B. Lam, MD, MBA1,2; Katherine Raphael, BA1; Winta T. Mehtsun, MD, MPH1,3; et alJessica Phelan, MA1; E. John Orav, PhD4,5; Ashish K. Jha, MD, MPH1,4; Jose F. Figueroa, MD, MPH1,6

subset of table


COVID-19 and Dark Skins

Overview Dark Skin and Vitamin D contains the following summary
FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D
African American Health Disparities are associated with low Vitamin D - Grant Feb 2021
Low Vitamin D increases health problems - independent of skin color

Dark Skin studies: Pregnancy (28 studies),  Genetics (13 studies),  Vitamin D Binding Protein (8 studies),  Vitamin D Receptor (7 studies),  Diabetes (24 studies),   Cardiovascular (18 studies),  Mortality (12 studies), Intervention (16 studies) Click here to see the studies

Blacks die more often than whites of many diseases (they have less vitamin D) – 2012 contains the following summary
Cancer Facts & Figures for African Americans Cancer.org

  • “African Americans have the highest death rate and shortest survival of any racial and ethnic group in the US for most cancers”
  • Has a huge number of tables and charts, Note: Vitamin D is not mentioned

Leading Causes of Death as of March 2018

All Ages Death rateBlackWhiteRatio
Heart diseases 217 1711.27
Cancer 1991701.17
Cerebrovascular diseases51361.4
Diabetes 40 192.0

Rates per 100,000    Age adjusted   Non-Hispanic

 Download the PDF from VitaminDWiki

Importance Racial disparities are well documented in cancer care. Overall, in the US, Black patients historically have higher rates of mortality after surgery than White patients. However, it is unknown whether racial disparities in mortality after cancer surgery have changed over time.

Objective To examine whether and how disparities in mortality after cancer surgery have changed over 10 years for Black and White patients overall and for 9 specific cancers.

Design, Setting, and Participants In this cross-sectional study, national Medicare data were used to examine the 10-year (January 1, 2007, to November 30, 2016) changes in postoperative mortality rates in Black and White patients. Data analysis was performed from August 6 to December 31, 2019. Participants included fee-for-service beneficiaries enrolled in Medicare Part A who had a major surgical resection for 9 common types of cancer surgery: colorectal, bladder, esophageal, kidney, liver, ovarian, pancreatic, lung, or prostate cancer.

Exposures Cancer surgery among Black and White patients.

Main Outcomes and Measures Risk-adjusted 30-day, all-cause, postoperative mortality overall and for 9 specific types of cancer surgery.

Results A total of 870 929 cancer operations were performed during the 10-year study period. In the baseline year, a total of 103 446 patients had cancer operations (96 210 White patients and 7236 Black patients). Black patients were slightly younger (mean [SD] age, 73.0 [6.4] vs 74.5 [6.8] years), and there were fewer Black vs White men (3986 [55.1%] vs 55 527 [57.7%]). Overall national mortality rates following cancer surgery were lower for both Black (−0.12%; 95% CI, −0.17% to −0.06% per year) and White (−0.14%; 95% CI, −0.16% to −0.13% per year) patients. These reductions were predominantly attributable to within-hospital mortality improvements (Black patients: 0.10% annually; 95% CI, −0.15% to −0.05%; P < .001; White patients: 0.13%; 95% CI, −0.14% to −0.11%; P < .001) vs between-hospital mortality improvements. Across the 9 different cancer surgery procedures, there was no significant difference in mortality changes between Black and White patients during the period under study (eg, prostate cancer: 0.35; 95% CI, 0.02-0.68; lung cancer: 0.61; 95% CI, −0.21 to 1.44).

Conclusions and Relevance These findings offer mixed news for policy makers regarding possible reductions in racial disparities following cancer surgery. Although postoperative cancer surgery mortality rates improved for both Black and White patients, there did not appear to be any narrowing of the mortality gap between Black and White patients overall or across individual cancer surgery procedures.

Created by admin. Last Modification: Wednesday June 16, 2021 22:12:57 GMT-0000 by admin. (Version 4)

Attached files

ID Name Comment Uploaded Size Downloads
14844 Cancer mortality race.jpg admin 10 Jan, 2021 54.15 Kb 357
14843 Cancer outcome racial differences.pdf admin 10 Jan, 2021 808.20 Kb 467