Fax: (713) 500 9264
Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer
Article first published online: 23 APR 2007
Copyright © 2007 American Cancer Society
Volume 109, Issue 11, pages 2161–2170, 1 June 2007
How to Cite
Du, X. L., Meyer, T. E. and Franzini, L. (2007), Meta-analysis of racial disparities in survival in association with socioeconomic status among men and women with colon cancer. Cancer, 109: 2161–2170. doi: 10.1002/cncr.22664
- Issue published online: 18 MAY 2007
- Article first published online: 23 APR 2007
- Manuscript Accepted: 1 FEB 2007
- Manuscript Revised: 19 DEC 2006
- Manuscript Received: 16 NOV 2006
- colon cancer;
- socioeconomic status;
Few studies have addressed racial disparities in survival for colon cancer by adequately incorporating both treatment and socioeconomic factors, and the findings from those studies have been inconsistent. The objectives of the current study were to systematically review the existing literature and provide a more stable estimate of the measures of association between socioeconomic status and racial disparities in survival for colon cancer by undertaking a meta-analysis.
For this meta-analysis, the authors searched the MEDLINE database to identify articles published in English from 1966 to August 2006 that met the following inclusion criteria: original research articles that addressed the association between race/ethnicity and survival in patients with colon or colorectal cancer after adjusting for socioeconomic status. In total, 66 full articles were reviewed, and 56 of those articles were excluded, which left 10 studies for the final analysis.
The pooled hazard ratio (HR) for African Americans compared with Caucasians was 1.14 (95% confidence interval [95% CI], 1.00–1.29) for all-cause mortality and 1.13 (95% CI, 1.01–1.28) for colon cancer-specific mortality. The test for homogeneity of the HR was statistically significant across the studies for all-cause mortality (Q = 31.69; P < .001) but was not significant across the studies for colon cancer-specific mortality (Q = 7.45; P = .114).
Racial disparities in survival for colon cancer between African Americans and Caucasians were only marginally significant after adjusting for socioeconomic factors and treatment. Attempts to modify treatment and socioeconomic factors with the objective of reducing racial disparities in health outcomes may have important clinical and public health implications. Cancer 2007. © 2007 American Cancer Society.