Differences in Colorectal Cancer Outcomes by Race and Insurance

Abstract

Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of the disparity in mortality is likely due to diagnosis at later stages of the disease, which could result from unequal access to screening. The purpose of this study is to determine the impact of race and insurance status on CRC outcomes among CRC patients. Data were drawn from the Surveillance, Epidemiology, and End Results database. Logistic regressions models were used to examine the odds of receiving treatment after adjusting for insurance, race, and other variables. Cox proportional hazard models were used to measure the risk of CRC death after adjusting for sociodemographic and tumor characteristics when associating race and insurance with CRC-related death. Blacks were diagnosed at more advanced stages of disease than whites and had an increased risk of death from both colon and rectal cancers. Lacking insurance was associated with an increase in CRC related-deaths. Findings from this study could help profile and target patients with the greatest disparities in CRC health outcomes.

Implications of Isoprostanes and Matrix Metalloproteinase-7 Having Potential Role in the Development of Colorectal Cancer in Males

“…SOD first shows increasing trend in the initial stages than move toward the decline trend in later stages, the findings were in contradiction with the previous study (12). GSH is involved in the inhibition of free radicals induced carcinogenesis, but its levels were reduced in CRC patients and also showed slight reversal in stage III, this finding was inconsistent with a recent study showing increasing trend at the first two stages then decreases in the remaining stages (22). …”

Predictors of health-related quality of life and association with survival may identify colorectal cancer patients at high risk of poor prognosis

“…In another study, African-Americans and Hispanics in the general population, have higher rates of depression compared to non-Hispanic Whites [23]. However, despite these similarities with the general population, CRC patients have poorer HR-QoL than the general population that may be attributed by existing racial disparities for CRC patients, including for later stage at diagnose in which African-American men have a 18% higher odds of late-stage CRC at diagnosis than non-Hispanic Whites [24]. Thus, these important findings indicate a critical need for future evaluations of HR-QoL racial disparities among CRC patients as a step to improve overall well-being and prognosis for African-American and Hispanic CRC patients.…”

Effect of an equal‐access military health system on racial disparities in colorectal cancer screening

“…This is contrary to prior research with national survey data, which suggest that black patients have lower screening rates than white patients. [29][30][31][32] Within our study population, this barrier is eliminated because enrollees are universally provided insurance. 6,7,28 The most commonly identified system-level barriers that affect CRC screening in the civilian population include a lack of access and a lack of insurance.…”