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Socioeconomic and demographic disparities in treatment for carcinomas of the colon and rectum
Article first published online: 28 JUN 2002
Copyright © 2002 American Cancer Society
Volume 95, Issue 1, pages 39–46, 1 July 2002
How to Cite
VanEenwyk, J., Campo, J. S. and Ossiander, E. M. (2002), Socioeconomic and demographic disparities in treatment for carcinomas of the colon and rectum. Cancer, 95: 39–46. doi: 10.1002/cncr.10645
- Issue published online: 28 JUN 2002
- Article first published online: 28 JUN 2002
- Manuscript Accepted: 2 JAN 2002
- Manuscript Revised: 27 DEC 2001
- Manuscript Received: 1 OCT 2001
- Centers for Disease Control and Prevention Cooperative Agreement. Grant Number: U75/CCU010709-05
- Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. Grant Number: NO1-CN-67009
- Fred Hutchinson Cancer Research Center
- colorectal neoplasms;
- socioeconomic factors;
- adjuvant therapy
The current study examined the relationship between socioeconomic and demographic factors and type of treatment for carcinomas of the colon and rectum. The National Institutes of Health and the National Cancer Institute recommend surgery followed by adjuvant chemo- and/or radiotherapy for Stage III colon and Stages II and III rectal carcinomas.
The authors linked Washington State's cancer registry and hospital discharge records and U.S. census data to assess socioeconomic and demographic factors related to treatment, controlling for clinical factors.
Compared to colon carcinoma patients under age 65 years, patients aged 75–84 years and 85 years or older were at higher risk for a treatment plan of surgery without adjuvant therapy (adjusted odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.3–4.7; OR = 14.1, CI = 6.3–31.4, respectively). Risk of no adjuvant therapy was more than doubled for patients in zip codes in the lowest quartile of per capita income compared to the top three quartiles (OR = 2.3, CI = 1.5–3.4) and for those with Medicare compared to private insurance (OR = 2.2, CI = 1.3–3.8). Older patients with rectal carcinoma were also at higher risk of a treatment plan that did not include adjuvant therapy.
The current findings suggest disparities in the provision of recommended medical procedures related to socioeconomic and demographic factors. Cancer 2002;95:39–46. © 2002 American Cancer Society.