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Marked variations in proximal colon cancer survival by race/ethnicity within the United States
1Department of Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA. RobertWong123@gmail.com
Goals:
To investigate the race/ethnicity and sex-specific variations in proximal colon cancer survival within the United States.
Background:
Recent studies suggest a shift toward more proximal distributions of colon cancers. Survival benefits from screening colonoscopy may be limited to left-sided cancers. Identifying groups at greatest risk for mortality from proximal cancers will help to target health care resources to address these disparities.
Study:
A retrospective cohort study from 1973 to 2004 using a large population-based cancer registry to investigate demographic variations in colon cancer survival.
Results:
Marked sex and race/ethnicity-specific variations in proximal colon cancer survival were observed. Overall 5-year survival was greatest in females (5-y survival, females: 44.5% and males: 41.7%, P<0.001) and in Asians (5-y survival, Asians: 50.4%, non-Hispanic whites: 43.1%, blacks: 39.7%, and Hispanics: 46.7%, P<0.001). Compared with females, males had significantly worse 5-year survival outcomes [odds ratios (OR), 0.77; 95% confidence intervals (CI), 0.75-0.79]. Compared with non-Hispanic whites, blacks had worse 5-year survival odds (OR, 0.74; 95% CI, 0.70-0.78) and Asians had better survival outcomes (OR, 1.16; 95% CI, 1.08-1.24).
Conclusions:
There exists significant sex and race/ethnicity-specific disparities in 5-year survival from proximal colon cancer. These differences may be explained by variations in delivery of health care between demographic groups or differences in disease biology specific to each group.
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