title: Treatment patterns for stage III colon cancer and factors related to receipt of postoperative chemotherapy in Louisiana.
abstract: This study examined treatment patterns among Louisiana residents diagnosed with stage III colon cancer in 2001 and factors that may be related to the receipt of chemotherapy. The data were collected from hospital medical records, supplemented by information from physician offices. We examined the association of chemotherapy with race (whites and blacks), gender, health insurance status (private versus public/none), hospital type (hospitals with a cancer program approved by the Commission on Cancer of the American College of Surgeons [COC hospital] versus other hospitals [non-COC hospital]), comorbidity, area of residence (rural versus urban), and level of poverty of the area (high poverty versus low poverty) in univariate analyses and logistic multivariate regression models. Our study found that all patients received cancer-directed surgery, and 66% received postoperative chemotherapy. The percentages of patients receiving chemotherapy were similar among race/gender groups. Patient age and hospital type were significantly associated with the receipt of chemotherapy even adjusting for other factors studied. The percentage of patients who received chemotherapy decreased with advancing age, and patients who were diagnosed at COC hospitals had a higher likelihood of receiving chemotherapy than their counterparts diagnosed at non-COC hospitals. Poverty and comorbidity were inversely associated (statistically significant) with the receipt of chemotherapy in univariate analysis. After adjusting for other factors, these associations were no longer significant. Although patients with private insurance were more likely to have chemotherapy than those with public insurance or no insurance, the difference was not significant. No difference was found in the receipt of chemotherapy between rural and urban patients.
authors.affiliation: School of Public Health, Louisiana State University, Health Sciences Center, New Orleans, USA.
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Wu
authors.forename: Vivien W
authors.initials: VW
authors.lastname: Chen
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Andrews
authors.forename: Lesong
authors.initials: L
authors.lastname: Chen
authors.forename: Meichin
authors.initials: M
authors.lastname: Hsieh
authors.forename: Elizabeth T H
authors.initials: ET
authors.lastname: Fontham
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant / Q000706:statistics & numerical data; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011182:Postoperative Care / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*