National health statistics in the United States indicate that blacks have lower survival rates from colorectal cancer than whites.
The disparity has been attributed to differences in stage at diagnosis, extent and quality of treatment, as well as socioeconomic factors.
|Blacks and whites had similar disease features at diagnosis.|
|Journal of Clinical Oncology|
In this study, researchers analyzed rectal cancer outcomes for blacks and whites who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP). This randomized trial setting enhanced uniformity in disease stage and treatment plan.
The researchers included 104 black and 1070 white patients from 2 serially conducted NSABP randomized trials for operable rectal cancer.
They compared recurrence-free survival, and survival, using statistical modeling to account for differences in patient and disease characteristics between the groups.
The research team found that both blacks and whites had similar disease features at diagnosis.
After adjustment for patient and tumor prognostic covariates, the black/white recurrence hazard ratio (HR) was 1.25, while the mortality HR was 1.45.
The team found that outcomes were improved for both groups in the more recent trial, which employed systemic adjuvant chemotherapy in all treatment arms.
Dr James Dignam’s team concluded, “Recurrence-free survival was modestly less favorable for blacks, whereas overall survival was more disparate”.
“Outcomes between groups were more comparable than those noted in national health statistics surveys and other studies.”
“Adequate treatment access and the identification of new prognostic factors that can identify patients at high risk of recurrence are needed to ensure optimal outcomes for rectal cancer patients of all racial/ethnic backgrounds.”