Racial disparities in advanced-stage colorectal cancer survival

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

Research output: Contribution to journalArticle

25 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)463-471
Number of pages9
JournalCancer Causes and Control
Volume24
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

Fingerprint

Colorectal Neoplasms
Survival
African Americans
Confidence Intervals
Proportional Hazards Models
Population
Registries
Colon
Adenocarcinoma
Incidence
Neoplasms

Keywords

  • African-American
  • Colon cancer
  • Metastatic
  • Survival
  • Young-onset

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Wallace, K., Hill, E. G., Lewin, D. N., Williamson, G., Oppenheimer, S., Ford, M. E., ... Alberg, A. J. (2013). Racial disparities in advanced-stage colorectal cancer survival. Cancer Causes and Control, 24(3), 463-471. https://doi.org/10.1007/s10552-012-0133-5

Racial disparities in advanced-stage colorectal cancer survival. / Wallace, Kristin; Hill, Elizabeth G.; Lewin, David N.; Williamson, Grace; Oppenheimer, Stephanie; Ford, Marvella E.; Wargovich, Michael J; Berger, Franklin G.; Bolick, Susan W.; Thomas, Melanie B.; Alberg, Anthony J.

In: Cancer Causes and Control, Vol. 24, No. 3, 03.2013, p. 463-471.

Research output: Contribution to journalArticle

Wallace, K, Hill, EG, Lewin, DN, Williamson, G, Oppenheimer, S, Ford, ME, Wargovich, MJ, Berger, FG, Bolick, SW, Thomas, MB & Alberg, AJ 2013, 'Racial disparities in advanced-stage colorectal cancer survival', Cancer Causes and Control, vol. 24, no. 3, pp. 463-471. https://doi.org/10.1007/s10552-012-0133-5
Wallace K, Hill EG, Lewin DN, Williamson G, Oppenheimer S, Ford ME et al. Racial disparities in advanced-stage colorectal cancer survival. Cancer Causes and Control. 2013 Mar;24(3):463-471. https://doi.org/10.1007/s10552-012-0133-5
Wallace, Kristin ; Hill, Elizabeth G. ; Lewin, David N. ; Williamson, Grace ; Oppenheimer, Stephanie ; Ford, Marvella E. ; Wargovich, Michael J ; Berger, Franklin G. ; Bolick, Susan W. ; Thomas, Melanie B. ; Alberg, Anthony J. / Racial disparities in advanced-stage colorectal cancer survival. In: Cancer Causes and Control. 2013 ; Vol. 24, No. 3. pp. 463-471.
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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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AU - Ford, Marvella E.

AU - Wargovich, Michael J

AU - Berger, Franklin G.

AU - Bolick, Susan W.

AU - Thomas, Melanie B.

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N2 - 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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