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 journalArticlepeer-review

34 Scopus citations


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
Issue number3
StatePublished - Mar 2013
Externally publishedYes


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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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