Sociodemographic Disparities in Rectal Cancer Outcomes within Academic Cancer Centers

Area of Science:

• Oncology
• Health Services Research
• Health Disparities

Background:

• Sociodemographic factors influence cancer care access and outcomes.
• Existing research is limited on whether disparities persist in high-level care settings.
• This study investigates rectal cancer outcomes in relation to sociodemographic status at academic cancer centers.

Purpose of the Study:

• To evaluate the relationship between sociodemographic status and rectal cancer outcomes.
• To determine if disparities in cancer care persist within academic institutions.
• To identify potential modifiable factors contributing to outcome differences.

Main Methods:

• Retrospective cohort study using the National Cancer Database.
• Inclusion of 127,023 patients with rectal cancer treated at academic centers.
• Primary outcome: overall survival; Secondary outcomes: mortality, time to treatment, readmission, length of stay.

Main Results:

• Black patients exhibited significantly worse overall survival (HR 1.10) and longer delays to treatment (3.23 days).
• Private insurance was associated with improved overall survival (HR 0.66) and reduced postoperative mortality.
• Significant disparities in survival and treatment timeliness were observed among sociodemographic groups.

Conclusions:

• Sociodemographic disparities in rectal cancer outcomes exist even within academic cancer centers.
• Delays in initiating treatment may contribute to poorer outcomes for certain patient groups.
• Addressing these disparities requires focused strategies to ensure equitable, evidence-based care.