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 language | English (US) |
|---|---|
| Pages (from-to) | 463-471 |
| Number of pages | 9 |
| Journal | Cancer Causes and Control |
| Volume | 24 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2013 |
| Externally published | Yes |
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Keywords
- African-American
- Colon cancer
- Metastatic
- Survival
- Young-onset
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
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 journal › Article
}
TY - JOUR
T1 - Racial disparities in advanced-stage colorectal cancer survival
AU - Wallace, Kristin
AU - Hill, Elizabeth G.
AU - Lewin, David N.
AU - Williamson, Grace
AU - Oppenheimer, Stephanie
AU - Ford, Marvella E.
AU - Wargovich, Michael J
AU - Berger, Franklin G.
AU - Bolick, Susan W.
AU - Thomas, Melanie B.
AU - Alberg, Anthony J.
PY - 2013/3
Y1 - 2013/3
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.
AB - 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.
KW - African-American
KW - Colon cancer
KW - Metastatic
KW - Survival
KW - Young-onset
UR - http://www.scopus.com/inward/record.url?scp=84878883951&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84878883951&partnerID=8YFLogxK
U2 - 10.1007/s10552-012-0133-5
DO - 10.1007/s10552-012-0133-5
M3 - Article
VL - 24
SP - 463
EP - 471
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 3
ER -