Disentangling Racial, Ethnic and Socioeconomic Disparities in Treatment for Colorectal Cancer

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Obrochta, Chelsea A. ; Murphy, James D. ; Tsou, Ming-Hsiang ; Thompson, Caroline A.
• Description:
  Background:
  
  Colorectal cancer (CRC) is curable if diagnosed early and treated properly. Black and Hispanic CRC patients are more likely to experience treatment delays, and/or receive lower standards of care. Socioeconomic deprivation may contribute to these disparities, but this has not been extensively quantified. We studied the interrelationship between patient race/ethnicity and neighborhood socioeconomic status (nSES) on receipt of timely appropriate treatment among CRC patients in California.
  
  Methods:
  
  26,870 White, Black, and Hispanic patients diagnosed with stage I-III CRC (2009-2013) in the California Cancer Registry were included. Logistic regression models were used to examine the association of race/ethnicity and nSES with three outcomes: undertreatment, >60-day treatment delay, and >90-day treatment delay. Joint effect models and mediation analysis were used to explore the interrelationships between race/ethnicity and nSES.
  
  Results:
  
  Hispanics and Blacks were at increased risk for undertreatment (Black OR=1.39, 95%CI=1.23-1.57; Hispanic OR=1.17, 95%CI=1.08-1.27), and treatment delay (Black/60-day OR=1.78, 95%CI=1.57-2.02; Hispanic/60-day OR=1.50, 95%CI=1.38-1.64), compared to Whites. Of the total effect (OR=1.15, 95%CI=1.07-1.24) of non-white race on undertreatment, 45.71% was explained by nSES.
  
  Conclusion:
  
  Lower nSES patients of any race were at substantially higher risk for undertreatment and treatment delay, and racial/ethnic disparities are reduced or eliminated among non-white patients living in the highest SES neighborhoods. Racial and ethnic disparities persisted after accounting for neighborhood socioeconomic status, and between the two, race/ethnicity explained a larger portion of the total effects.
  
  Impact:
  
  This research improves our understanding of how socioeconomic deprivation contributes to racial/ethnic disparities in colorectal cancer.
  
  
• Keywords:
  Aged Aged, 80 And Over Black People California CHEMOTHERAPY/CHEMOTHERAPY Colorectal Neoplasms DESCRIPTIVE STUDIES/Cancer Disparities Female GASTROINTESTINAL CANCERS/Colorectal Cancer Healthcare Disparities Health Status Disparities Hispanic Or Latino Humans Male Middle Aged RADIATION ONCOLOGY/RADIATION ONCOLOGY Registries Social Class SURGICAL ONCOLOGY/SURGICAL ONCOLOGY Time-to-Treatment White People

  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 30(8):1546-1553
• Pubmed ID:
  34108139
• Pubmed Central ID:
  PMC8338765
• Document Type:
  Journal Article
• Funding:
  HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; U54 CA132384/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; KL2 TR001444/TR/NCATS NIH HHSUnited States/ ; U54 CA132379/CA/NCI NIH HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/ ; L30 TR001787/TR/NCATS NIH HHSUnited States/
• Volume:
  30
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f43a853b671293c207285ebc1370b86a0e0ede8ae094d8f30c27ddf8b0a6cb0a
• Download URL:
  https://stacks.cdc.gov/view/cdc/108719/cdc_108719_DS1.pdf
• File Type:
  [PDF - 136.77 KB ]