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Presealed as a poster at the annual meeting of the American Gastroenterological Association, San Francisco, California, May 20, 1996.
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Original Article
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Race, treatment, and survival among colorectal carcinoma patients in an equal-access medical system†
Article first published online: 6 DEC 1998
DOI: 10.1002/(SICI)1097-0142(19980615)82:12<2312::AID-CNCR3>3.0.CO;2-U
Copyright © 1998 American Cancer Society
Additional Information
How to Cite
Dominitz, J. A., Samsa, G. P., Landsman, P. and Provenzale, D. (1998), Race, treatment, and survival among colorectal carcinoma patients in an equal-access medical system. Cancer, 82: 2312–2320. doi: 10.1002/(SICI)1097-0142(19980615)82:12<2312::AID-CNCR3>3.0.CO;2-U
- †
Publication History
- Issue published online: 6 DEC 1998
- Article first published online: 6 DEC 1998
- Manuscript Revised: 23 JAN 1998
- Manuscript Accepted: 23 JAN 1998
- Manuscript Received: 27 AUG 1997
Funded by
- VA Health Services Research Fellowhip
- VA Health Services Research Career Development Program.
- Abstract
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- Cited By
Keywords:
- colorectal neoplasms;
- epidemiology;
- racial stocks;
- surgery;
- survival;
- chemotherapy;
- adjuvant;
- radiation oncology;
- veterans
Abstract
BACKGROUND
The aim of this study was to assess the influence of race on the treatment and survival of patients with colorectal carcinoma.
METHODS
This retrospective cohort study included all white or black male veterans given a new diagnosis of colorectal carcinoma in 1989 at Veterans Affairs Medical Centers nationwide. After adjusting for patient demographics, comorbidity, distant metastases, and tumor location, the authors determined the likelihood of surgical resection, chemotherapy, radiation therapy, and death in each case.
RESULTS
Of the 3176 veterans identified, 569 (17.9%) were black. Bivariate analyses and logistic regression revealed no significant differences in the proportions of patients undergoing surgical resection (70% vs. 73%, odds ratio 0.92, 95% confidence interval 0.74-1.15), chemotherapy (23% vs. 23%, odds ratio 0.99, 95% confidence interval 0.78-1.24), or radiation therapy (17% vs. 16%, odds ratio 1.10, 95% confidence interval 0.85-1.43) for black versus white patients. Five-year relative survival rates were similar for black and white patients (42% vs. 39%, respectively; P = 0.16), though the adjusted mortality risk ratio was modestly increased (risk ratio 1.13, 95% confidence interval 1.01-1.28).
CONCLUSIONS
Overall, race was not associated with the use of surgery, chemotherapy, or radiation therapy in the treatment of colorectal carcinoma among veterans seeking health care at Veterans Affairs Medical Centers. Although mortality from all causes was higher among black veterans with colorectal carcinoma, this finding may be attributed to underlying racial differences associated with survival. This study suggests that when there is equal access to care, there are no differences with regard to race. Cancer 1998;82:2312-2320. © 1998 American Cancer Society.