Determinants of Black/White Differences in Colon Cancer Survival

Mayberry, Robert; Coates, Ralph J.; Hill, Holly A.; Click, Lorie A.; Chen, Vivien W.; Austin, Donald F.; Redmond, Carol; Fenoglio-Preiser, Cecelia; Hunter, Carrie P.; Haynes, Michelle; Muss, Hyman B.; Wesley, Margaret N.; Greenberg, Raymond S.; Edwards, Brenda K.

doi:10.1093/jnci/87.22.1686

Cited by 197 publications

(125 citation statements)

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“…Pathologist inter-and intraobserver variation in the classification of MPA type could not be controlled for, but this would be expected to weaken rather than exaggerate the observed association with SE status. As previously reported (Mayberry et al, 1995), there is a higher risk of MPA tumour subtype in younger patients. There was a previously unreported, excess risk of MPA subtype in patients with proximal subsites tumours and in women.…”

Section: Discussionsupporting

confidence: 78%

“…Indeed, the results show that least-deprived (affluent) patients are more likely to have tumours of MPA subtype and proximal subsite. It is possible that there has been a degree of under-ascertainment of MPA subtype in the study dataset À6.4% compared with about 13% reported in US studies (Mayberry et al, 1995;Chen et al, 1997), although it is unclear whether this difference represents under-diagnosis of MPA subtype in the UK or overdiagnosis in the US. For MPA-type underdiagnosis to bias the results, the quality of histopathological diagnosis would have had to differ by deprivation status, which is unlikely.…”

Section: Discussionmentioning

confidence: 85%

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Socioeconomic variation in colon cancer tumour factors associated with poorer prognosis

2003

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 85%

Socioeconomic variation in colon cancer tumour factors associated with poorer prognosis

2003

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“…Analysis of the overall survival rate by ethnic group revealed that black patients (n=92) had a 5 year survival rate of 50%. This contradicts many earlier reports, in particular, studies in America where African American patients are reported to present late to clinicians, leading to an overall reduction in survival compared to white patients [12]. In the Network, 29.3% of the tumours in black patients were rectal cancer (C20) and 28.3% of the cancers (C18.0-18.3) were right sided; caecum to hepatic flexure.…”

Section: Discussioncontrasting

confidence: 66%

Colorectal Cancer Demographics and Survival in a London Cancer Network

Gurprashad¹,

Khan²,

Oldman³

et al. 2017

CRJ

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Abstract:The purpose of this study was to examine whether a relationship exists between age, ethnicity, gender and survival of patients within a London Cancer Network. All patients with non metastatic colorectal cancer diagnosed and treated within the South West London Cancer Network between January 2001 and January 2006 were included for analysis. Consent was gained from all hospitals within the London Cancer Network, and data was subsequently requested from the Thames Cancer Registry. In total, 3151 patients were analysed. The results demonstrated that from 2003 there was a yearly increase in new cancer diagnosis. The ratio of male to female patients was approximately equal over the time period (51.5% male, 48.5% female). The overall mean patient age at diagnosis was 70.76 years. Asian, black and mixed race patients had better survival rates than white European patients (hazard ratios 0.96, 0.87, 0.96 respectively). Patients in the age cohort '50-59 years' had a 5 year survival rate of 57.8 months (hazard ratio 1.63), whilst the 'under 40 years' age cohort had the longest 5 year survival rate of 67.4 months. When comparing tumour sites, patients with rectosigmoid tumours had the lowest 5 year survival rate (hazard ratio 1.12), and those with rectal tumours (n=816, hazard ratio 0.88) had the longest 5 year survival rate. Median and overall survival for all patients was 38.84 months and 42.3% respectively. Surgery with neoadjuvant therapy resulted in the longest 5 year survival rate at 62.8%. Surgery alone had a 5 year survival rate of 43%. The results could be used to help design a prognostic indicator tool as a means by which to assist clinicians in providing patients with information on survival outcomes.

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“…10,12 In our study, we observed significant differences in tumor stage, especially between blacks and whites. Because colorectal carcinogenesis progresses through a slow, multistage process, 2 the magnitude of racial differences for regional and distant tumors likely reflect delays in diagnosis, specifically, elapsed time from malignant transformation to cancer detection.…”

Section: Discussionmentioning

confidence: 45%

“…[5][6][7][8] Previous studies in the general population established that blacks with colorectal cancer were significantly more likely to be diagnosed at an advance stage and to have lower survival rates compared with whites. 6,9,10 In contrast, Asians/ Pacific Islanders and, in some reports, Hispanics have lower incidence and mortality from colorectal cancer than whites. 5,6 Although the exact mechanisms for racial disparities in colorectal cancer are not clear, the results of several studies suggest that inequalities in access to health care related to colorectal cancer prevention and treatment, including lack of health insurance or a regular source of care, may be important factors.…”

mentioning

confidence: 99%

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

Doubeni

Field

Buist

et al. 2006

Cancer

110

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BACKGROUND: Despite declining death rates from colorectal cancer (CRC), racial disparities have continued to increase. In this study, the authors examined disparities in a racially diverse group of insured patients. METHODS: This study was conducted among patients who were diagnosed with CRC from 1993 to 1998, when they were enrolled in integrated healthcare systems. Patients were identified from tumor registries and were linked to information in administrative databases. The sample was restricted to non-Hispanic whites (n = 10,585), non-Hispanic blacks (n = 1479), Hispanics (n = 985), and Asians/Pacific Islanders (n = 909). Differences in tumor stage and survival were analyzed by using polytomous and Cox regression models, respectively. RESULTS: In multivariable regression analyses, blacks were more likely than whites to have distant or unstaged tumors. In Cox models that were adjusted for nonmutable factors, blacks had a higher risk of death from CRC (hazard ratio [HR], 1.17; 95% confidence interval [95% CI], 1.06-1.30). Hispanics had a risk of death similar to whites (HR, 1.04; 95% CI, 0.92-1.18), whereas Asians/Pacific Islanders had a lower risk of death from CRC (HR, 0.89; 95% CI, 0.78-1.02). Adjustment for tumor stage decreased the HR to 1.11 for blacks, and the addition of receipt of surgical therapy to the model decreased the HR further to 1.06. The HR among Hispanics and Asians/Pacific Islanders was stable to adjustment for tumor stage and surgical therapy. CONCLUSIONS: The relation between race and survival from CRC was complex and appeared to be related to differences in tumor stage and therapy received, even in insured populations. Targeted interventions to improve the use of effective screening and treatment among vulnerable populations may be needed to eliminate disparities in CRC

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Determinants of Black/White Differences in Colon Cancer Survival

Abstract: Because the racial disparity was confined to earlier stages, future studies should investigate whether blacks have more advanced disease at diagnosis and whether less aggressive treatment is provided because of understanding.

Cited by 197 publications

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Socioeconomic variation in colon cancer tumour factors associated with poorer prognosis

Socioeconomic variation in colon cancer tumour factors associated with poorer prognosis

Colorectal Cancer Demographics and Survival in a London Cancer Network

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

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