Rho J, Ahn C, Gao A, Sawicki GS, Keller A, Jain R. Disparities in Mortality of Hispanic Cystic Fibrosis Patients in the United States: A National and Regional Cohort Study. Am J Resp Crit Care Med 2018; May 9; DOI: 10.1164/rccm.201711-2357OC. [Epub ahead of print].
Although cystic fibrosis (CF) predominantly affects Caucasians, it can affect other ethnic populations including Hispanics. No prior study has evaluated long-term survival in Hispanics with CF compared to their non-Hispanic counterparts. Using CF Registry Data in the United States, this study found that Hispanics died at a much younger age (mean age 22.4 +/- 9.9 years) than non-Hispanics (28.1 +/- 10.0 years; p<0.0001) and had a 27% higher rate of death overall. In order to fully address the health disparities seen in the Hispanic population, genetic and socioeconomic factors may need to be taken into account at CF Centers.
Prevalence of CF differs by race/ethnicity: 1 in 2,500 individuals among Caucasians; 1 in 8,000 among Hispanic-Americans; 1 in 15,000 among African-Americans; and 1 in 35,000 Asian-Americans. While the predicted survival age for individuals with CF has increased from 29 years old in 1986-1990 to 47 years old by 2016, Hispanic-Americans with CF have been found in some local cohorts to have higher mortality than non-Hispanic CF patients. This was a retrospective cohort analysis using the largest national CF database maintained by the Cystic Fibrosis Foundation. Overall, 8.4% of patients captured in the CF Registry database self-identify as Hispanic. Alongside differences in age at death and death rates mentioned above, Hispanics were less likely to have CF-related diabetes but also less likely to undergo lung transplant. When analyzed by region, Hispanics in the Midwest, Northeast, and West had shorter median survivals compared to Non-Hispanics, but in the South survival was equivalent. No current tools or interventions are in place to address this disparity; further study and clinical attention are needed to address this subpopulation.