A population-based study of survival among elderly persons diagnosed with colorectal cancer: does race matter if all are insured? (United States)

Abstract

In this population-based study of elderly Tennesseans covered by both Medicaid and Medicare, there were no significant differences in outcomes, raising the possibility that 'equal coverage*rsquo; leads to more equal outcomes.

Complexity of care needs and unstaged cancer in elders: A population-based study

“…As noted earlier, the review of the literature points to a lack of consistency among researchers relative to whether to exclude unstaged cases from the analysis [18,19,20], to group unstaged cases with latestaged cancers [21,22], or even to analyze unstaged cases in a separate stage category [11,14,23,24]. SEER reports survival rates for unstaged cases that are somewhat more favorable than for those with distant stage cancer, but less favorable than for those with regional stage cancer [3,4,5], and a previous study has documented differences in survival patterns among unstaged cases when analysis was performed in age-specific strata [11].…”

Racial differences in tumor stage and survival for colorectal cancer in an insured population

“…38,39 However, in a study that was restricted to patients who were enrolled in both Medicaid and Medicare at the time of their colorectal cancer diagnosis, no racial difference in survival was observed. 40 Dignam et al reported no significant racial difference in cancer-specific survival among patients with colon cancer (HR, 1.08; 95% CI, 0.94-1.25) or rectal cancer (HR, 1.25; 95% CI, 0.94-1.66) who were enrolled in the National Surgical Adjuvant Breast and Bowel Project trials, in which treatment regimens are controlled more rigorously. 35,36 Analyses of patients enrolled in the Phase III Intergroup Trial 0089, which assessed the efficacy of adjuvant chemotherapy (1988)(1989)(1990)(1991)(1992), also indicated that there was no racial difference in survival.…”

Clinico-Pathological Caracteristics, Therapeutic Features and Post-operative Course of Colorectal Cancer in Elderly Patients

“…The exact reasons are unknown, but theories of cancer development in the elderly are applicable to colorectal cancer: (1) longer duration of exposure and increased cellular susceptibility to carcinogens, (2) diminished ability to repair damaged DNA, (3) oncogene activation or amplification and tumour suppressor gene loss or malfunction, and (4) diminished immune surveillance mechanisms [3,4].…”