Racial differences in colorectal cancer mortality. The importance of stage and socioeconomic status.
This investigation studies racial and socioeconomic differences in mortality from colorectal cancer, and how they vary by stage and age at diagnosis. Cox proportional hazards models were used to estimate the hazard ratio of dying from colorectal cancer, controlling for tumor characteristics and sociodemographic factors. Black adults had a greater risk of death from colorectal cancer, especially in early stages. The gender gap in mortality is wider among blacks than whites. Differences in tumor characteristics and socioeconomic factors each accounted for approximately one third of the excess risk of death among blacks. Effects of socioeconomic factors and race varied significantly by age. Higher stage-specific mortality rates and more advanced stage at diagnosis both contribute to the higher case-fatality rates from colorectal cancer among black adults, only some of which is due to socioeconomic differences. Socioeconomic and racial factors have their most significant effects in different age groups.
Marcella
S
S
Department of Environmental and Community Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Piscataway, NJ 08854, USA. marcelsw@umdnj.edu
Miller
J E
JE
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000235:genetics; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000235:genetics / Q000401:mortality* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010414:Pennsylvania / Q000453:epidemiology; D011159:Population Surveillance; D011203:Poverty / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D013997:Time Factors; D044465:White People / Q000235:genetics / Q000706:statistics & numerical data*