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Changes in Colorectal Cancer 5-Year Survival Disparities in California, 1997-2014
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May 05 2020
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Source: Cancer Epidemiol Biomarkers Prev. 29(6):1154-1161
[PDF-120.45 KB]
Details:
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Alternative Title:Cancer Epidemiol Biomarkers Prev
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Personal Author:
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Description:Background:
Colorectal cancer (CRC) incidence and mortality have declined with increased screening and scientific advances in treatment. However, improvement in CRC outcomes have not been equal for all groups and disparities have persisted over time.
Methods:
Data from the California Cancer Registry were used to estimate changes in 5-year CRC-specific survival over three diagnostic time periods 1997–2002, 2003–2008, and 2009–2014. Analyses included all patients in California with CRC as a first primary malignancy. Multivariable Cox proportional hazard regression models were used to evaluate the effect of race/ethnicity, insurance status, and neighborhood socioeconomic status (nSES) on 5-year CRC-specific survival.
Results:
Based on a population-based sample of 197,060 CRC cases, racial/ethnic survival disparities decreased over time among non-Hispanic Blacks (NHB) compared to non-Hispanic Whites (NHW), after adjusting for demographic, clinical, and treatment characteristics. For cases diagnosed 1997–2002, CRC-specific hazard rates were higher for NHB (HR, 1.12; 95% CI, 1.06–1.19) and lower for Asians/Pacific Islanders (HR, 0.92; 95% CI, 0.87–0.96) and Hispanics (HR, 0.94; 95% CI, 0.90–0.99) compared to NHW. In 2009–2014, CRC-specific hazard rate for NHB was not significantly different to the rate observed for NHW (HR,1.03; 95% CI, 0.97–1.10). There were no changes in disparities in nSES, but increasing disparities by health insurance status.
Conclusions:
We found a decrease in survival disparities over time by race/ethnicity, but a persistence of disparities by neighborhood socioeconomic status and health insurance status.
Impact:
Further investigation into the drivers for these disparities can help direct policy and practice toward health equity for all groups.
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Source:
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Pubmed ID:32371552
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Pubmed Central ID:PMC7269803
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