title: Race does not impact colorectal cancer treatment or outcomes with equal access.
abstract: 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.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA.
authors.forename: Monique O
authors.initials: MO
authors.lastname: Hassan
authors.forename: Zachary
authors.initials: Z
authors.lastname: Arthurs
authors.forename: Vance Y
authors.initials: VY
authors.lastname: Sohn
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
mesh_terms: 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