title: Factors associated with colon cancer stage at diagnosis.
abstract: We analyzed data from 1998-2004 from the National Cancer Data Base to evaluate associations between patient/treatment facility factors and stage at diagnosis for all colon cancers combined and by anatomic location. Compared to patients with private insurance, uninsured patients were significantly more likely to present with advanced-stage disease; Medicaid patients had likelihoods of advanced-stage colon cancer in-between those of privately insured and uninsured patients. Increased odds of advanced-stage colon cancer at diagnosis were also observed among Black (vs. White) patients, women (vs. men), and patients from low socioeconomic status (SES) regions (vs. those from higher SES regions). While the likelihood of advanced-stage disease at diagnosis decreased in later years overall, this decrease was not observed among patients with ascending colon cancers. Screening disparities may lead to more advanced stage at diagnosis among colon cancer patients; programs to improve access to screening among underserved populations may address this disparity.
authors.affiliation: Division of Health Services and Social Policy Research, RTI International, 701 13th Street NW, Suite 750, Washington, DC 20005, USA. mhalpern@rti.org
authors.forename: Michael T
authors.initials: MT
authors.lastname: Halpern
authors.forename: Alexandre L
authors.initials: AL
authors.lastname: Pavluck
authors.forename: Clifford Y
authors.initials: CY
authors.lastname: Ko
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Ward
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000473:pathology*; D055088:Early Detection of Cancer; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D017149:Private Sector / Q000706:statistics & numerical data; D011379:Prognosis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data