Black/white differences in colorectal tumor location in a national sample of hospitals

This article describes a retrospective study that compared the distribution of colorectal tumors among black and white discharges. A total of 188,109 discharges with colorectal cancer were selected from the Hospital Cost and Utilization Project, a national sample of hospitals with 34 million patient discharges from 1980 to 1987. Black/white differences were small for right, left, and rectal tumors; however, black discharges had a higher percentage of colorectal tumors with sites unspecified. From 1980 to 1987, 295 per 1000 discharges of blacks had an unspecified tumor location, compared with 229 per 1000 discharges of whites (a 29% difference). Black discharges had a higher proportion of unspecified tumors than whites regardless of cancer severity, discharge status, procedure type, age, sex, expected third-party payer, and year. Black/white differences were maintained across hospital characteristics (region, rural/urban location, teaching status, bed size, and ownership). Differences in specification of tumor site may be an indicator of poor continuity of care, poor access, or other quality-related measures.