Race does not impact colorectal cancer treatment or outcomes with equal access.
BACKGROUND
Ethnicity is implicated as a factor for disparate outcomes in colorectal cancer. We sought to evaluate this relationship at a military medical center organized to deliver equitable health care.


METHODS
Retrospective analysis of colorectal cancer patients comparing demographics, grade, American Joint Committee on Cancer (AJCC) stage, and adjuvant therapy.


RESULTS
From January 1994 to January 2004, 398 patients were treated with colorectal cancer (74 [19%] nonwhites). Comparatively, nonwhites were younger and had fewer stage II tumors with a increased proportion of stage III tumors (P < .01). With a median follow-up period of 52 (0-151) months, there were no disparities in surgical resection, adjuvant therapy, or disease recurrence. Kaplan-Meier analysis revealed no disparity in disease-free and cancer-specific survival (P = .585 and P = .132); Cox regression revealed increased age and AJCC stage III as the only independent predictors of lower survival (P < .05).


CONCLUSIONS
Ethnicity was associated with differences in age and AJCC stage at presentation. In an equitable health care system, these differences did not impact patients' treatment or survival.
Hassan
Monique O
MO
Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA.
Arthurs
Zachary
Z
Sohn
Vance Y
VY
Steele
Scott R
SR
D000230:Adenocarcinoma / Q000208:ethnology / Q000401:mortality / Q000628:therapy*; D000368:Aged; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000628:therapy*; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome