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Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death.

Publication ,  Journal Article
Adrianzen-Herrera, DA; Koh, I; Gangaraju, R; Akinyemiju, T; Zakai, NA
Published in: Cancer Med
April 2023

BACKGROUND: Cytopenia is associated with cancer through mechanisms including clonal hematopoiesis and chronic inflammation. Cytopenia is more prevalent in Black people but its relationship with racial disparities in cancer mortality is unknown. METHODS: Cytopenia was defined in 19,028 Black and White participants recruited between 2003 and 2007 for the REasons for Geographic and Racial Differences in Stroke cohort, based on age-, sex-, and race-adjusted ranges for blood counts. Cancer death was ascertained from Social Security Death and National Death Indexes. Multivariable Cox models estimated the risk of cancer mortality associated with cytopenia, adjusting for demographics (model1), anemia and cancer risk factors (model2), and socioeconomics (model3). Racial differences in the cytopenia-cancer death association were tested by cross-product interaction terms. RESULTS: Cytopenia was identified in 383 (2%) participants, 250 (65%) White, and 113 (35%) Black people. With median follow-up 11.3 years, 1,224 (6.4%) cancer deaths occurred. Cytopenia was associated with increased risk of cancer mortality in model1 (HR = 1.57, 95%CI 1.15-2.24), model2 (HR = 1.67, 95%CI 1.22-2.30), and model3 (HR = 1.59, 95%CI 1.17-2.17). Participants with cytopenia had twofold increased cumulative incidence of cancer death (13% vs. 6.5%, p < 0.01). Race by cytopenia interaction terms showed higher HR for cancer death in Black compared to White participants: 2.01 versus 1.41 (pinteraction  = 0.016, model1), 2.12 versus 1.45 (pinteraction  = 0.009, model2), and 1.82 versus 1.44 (pinteraction  = 0.04, model3). CONCLUSION: In this large, observational biracial prospective study, cytopenia was a risk factor for cancer death, with stronger association in Black than White people. Though race impacted the association of cytopenia with cancer mortality, cytopenia was not a mediator of the racial disparity in cancer mortality.

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Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

April 2023

Volume

12

Issue

7

Start / End Page

8639 / 8651

Location

United States

Related Subject Headings

  • White
  • United States
  • Risk Factors
  • Race Factors
  • Prospective Studies
  • Neoplasms
  • Humans
  • Anemia
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis
 

Citation

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Adrianzen-Herrera, D. A., Koh, I., Gangaraju, R., Akinyemiju, T., & Zakai, N. A. (2023). Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death. Cancer Med, 12(7), 8639–8651. https://doi.org/10.1002/cam4.5570
Adrianzen-Herrera, Diego A., Insu Koh, Radhika Gangaraju, Tomi Akinyemiju, and Neil A. Zakai. “Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death.Cancer Med 12, no. 7 (April 2023): 8639–51. https://doi.org/10.1002/cam4.5570.
Adrianzen-Herrera DA, Koh I, Gangaraju R, Akinyemiju T, Zakai NA. Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death. Cancer Med. 2023 Apr;12(7):8639–51.
Adrianzen-Herrera, Diego A., et al. “Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death.Cancer Med, vol. 12, no. 7, Apr. 2023, pp. 8639–51. Pubmed, doi:10.1002/cam4.5570.
Adrianzen-Herrera DA, Koh I, Gangaraju R, Akinyemiju T, Zakai NA. Association between peripheral blood cytopenia and cancer mortality: A race-specific risk factor for cancer death. Cancer Med. 2023 Apr;12(7):8639–8651.
Journal cover image

Published In

Cancer Med

DOI

EISSN

2045-7634

Publication Date

April 2023

Volume

12

Issue

7

Start / End Page

8639 / 8651

Location

United States

Related Subject Headings

  • White
  • United States
  • Risk Factors
  • Race Factors
  • Prospective Studies
  • Neoplasms
  • Humans
  • Anemia
  • 3211 Oncology and carcinogenesis
  • 1112 Oncology and Carcinogenesis