Short-term surgical outcomes for colon adenocarcinoma: Racial-Ethnic comparisons in a universal access health system

Yvonne L Eaglehouse ¹, Sarah Darmon ¹, Michele M Gage ²

⁰Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland, 20814, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 6720A Rockledge Drive, Suite 310, Bethesda, MD, USA.

Surgical Oncology +

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September 18, 2025

View abstract on PubMed

Summary

In the Military Health System, racial-ethnic groups showed no significant differences in colon cancer surgery outcomes. This suggests universal access to care may reduce disparities in surgical treatment and recovery.

Area Of Science

Oncology
Health Services Research
Surgical Outcomes

Background

Racial-ethnic disparities in colon cancer treatment and survival are linked to access to care.
Limited data exists on racial-ethnic differences in colon cancer surgery and postoperative outcomes.
The Military Health System (MHS) offers universal access to care, making it ideal for studying these disparities.

Purpose Of The Study

To investigate racial-ethnic differences in colon cancer surgery.
To examine short-term postoperative outcomes following colectomy.
To determine if access to care plays a role in surgical disparities within the MHS.

Main Methods

Utilized the MilCanEpi database for patients diagnosed with stage I-III colon adenocarcinoma (2001-2014).
Included patients aged 18+ who underwent colectomy.
Analyzed outcomes: positive surgical margins, lymphadenectomy adequacy, 30-day complications, and readmissions using multivariable Poisson regression.

Main Results

Included 157 Asian/Pacific Islander, 258 non-Hispanic Black, 111 Hispanic, and 1131 non-Hispanic White patients.
No significant overall differences in surgical outcomes or 30-day outcomes between minority groups and non-Hispanic Whites.
Hispanic patients had a lower risk of bowel obstruction (ARR=0.55) compared to non-Hispanic Whites.

Conclusions

The MHS demonstrated no significant racial-ethnic disparities in surgical aspects or 30-day postoperative outcomes for colon cancer.
Universal access to care in the MHS may mitigate racial-ethnic differences in surgical outcomes.
Further research can explore specific factors influencing the observed lower risk of bowel obstruction in Hispanic patients.

Keywords:

Colectomy Complications Hospital readmission

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