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Cancer Causes & Control
Published in: Cancer Causes & Control 3/2013

01-03-2013 | Original paper

Racial disparities in advanced-stage colorectal cancer survival

Authors: Kristin Wallace, Elizabeth G. Hill, David N. Lewin, Grace Williamson, Stephanie Oppenheimer, Marvella E. Ford, Michael J. Wargovich, Franklin G. Berger, Susan W. Bolick, Melanie B. Thomas, Anthony J. Alberg

Published in: Cancer Causes & Control | Issue 3/2013

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Abstract

Purpose

African-Americans (AA) have a higher incidence of and lower survival from colorectal cancer (CRC) compared with European Americans (EA). In the present study, statewide, population-based data from South Carolina Central Cancer Registry are used to investigate the relationship between race and age on advanced-stage CRC survival.

Methods

The study population was comprised of 3,865 advanced pathologically documented colon and rectal adenocarcinoma cases diagnosed between 01 January 1996 and 31 December 2006: 2,673 (69 %) EA and 1,192 (31 %) AA. Kaplan–Meier methods were used to generate median survival time and corresponding 95 % confidence intervals (CI) by race, age, and gender. Factors associated with survival were evaluated by fitting Cox proportional hazards regression models to generate hazard ratios (HR) and 95 % CI.

Results

We observed a significant interaction between race and age on CRC survival (p = 0.04). Among younger patients (<50 years), AA race was associated with a 1.34 times (95 % CI 1.06–1.71) higher risk of death compared with EA. Among older patients, we observed a modest increase in risk of death among AA men compared with EA [HR 1.16 (95 % CI 1.01–1.32)] but no difference by race between women [HR 0.94 (95 % CI 0.82–1.08)]. Moreover, we observed that the disparity in survival has worsened over the past 15 years.

Conclusions

Future studies that integrate clinical, molecular, and treatment-related data are needed for advancing understanding of the racial disparity in CRC survival, especially for those <50 years old.
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Metadata
Title
Racial disparities in advanced-stage colorectal cancer survival
Authors
Kristin Wallace
Elizabeth G. Hill
David N. Lewin
Grace Williamson
Stephanie Oppenheimer
Marvella E. Ford
Michael J. Wargovich
Franklin G. Berger
Susan W. Bolick
Melanie B. Thomas
Anthony J. Alberg
Publication date
01-03-2013
Publisher
Springer Netherlands
Published in
Cancer Causes & Control / Issue 3/2013
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-012-0133-5

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