A team from Nashville, Tennessee, USA, investigated disparities in colorectal cancer outcomes between black and white patients.
They conducted a 10-year retrospective review of all patients with colorectal cancer, using tumor registries at a city hospital (n = 83) and a university medical center (n = 585) in the same city.
Stage at diagnosis, curative surgical resection, use of adjuvant treatment, overall, disease-free, and stage-specific survival, and socioeconomic status were all assessed.
Patients with non-white, non-black ethnicity (4% overall) were excluded from the study.
Differences in stage and treatments were compared using the chi-squared test, and median survival rates were compared using log-rank tests.
Significantly more black patients were treated at the city hospital (53%) versus the university medical center (11%).
| Reduced survival may be due to biologic factors or non-cancer-related health conditions.
| Archives of Surgery |
No differences were identified in stage distribution or treatments received between hospitals or between black and white patients.
Significantly worse survival was noted among patients treated at the city hospital (2.1 vs 5.3 years).
There was also worse survival among black patients treated at both institutions (city hospital: 1.4 vs 2.1 years, and university hospital: 3.2 vs 5.7 years).
The researchers found that disease-free survival rates showed similar significant reductions for black patients at both institutions.
There was found to be no association between survival and socioeconomic status at either institution.
Dr L. James Wudel, Jr., of the Vanderbilt University Medical Center, Nashville, concluded on behalf of his colleagues, "The marked reductions in overall and disease-free survival for black patients with colorectal cancer do not seem to be related to variation in treatment.
"However, they may be due to biologic factors or non-cancer-related health conditions."