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Sex differences in hospital readmission among colorectal cancer patients
Juan Ramon González1, Esteve Fernandez, Víctor Moreno
1Cancer Prevention and Control Unit, Institut Català d'Oncologia, Barcelona, Spain.
Background:
While several studies have analysed sex and socioeconomic differences in cancer incidence and mortality, sex differences in oncological health care have been seldom considered.
Objective:
To investigate sex based inequalities in hospital readmission among patients diagnosed with colorectal cancer.
Design:
Prospective cohort study.
Setting:
Hospital Universitary in L'Hospitalet (Barcelona, Spain).
Participants:
Four hundred and three patients diagnosed with colorectal between January 1996 and December 1998 were actively followed up until 2002. Main outcome measurements and
Methods:
Hospital readmission times related to colorectal cancer after surgical procedure. Cox proportional model with random effect (frailty) was used to estimate hazard rate ratios and 95% confidence intervals of readmission time for covariates analysed.
Results:
Crude hazard rate ratio of hospital readmission in men was 1.61 (95% CI 1.21 to 2.15). When other significant determinants of readmission were controlled for (including Dukes's stage, mortality, and Charlson's index) a significant risk of readmission was still present for men (hazard rate ratio: 1.52, 95% CI 1.17 to 1.96).
Conclusions:
In the case of colorectal cancer, women are less likely than men to be readmitted to the hospital, even after controlling for tumour characteristics, mortality, and comorbidity. New studies should investigate the role of other non-clinical variable such as differences in help seeking behaviours or structural or personal sex bias in the attention given to patients.
