Marked variations in proximal colon cancer survival by race/ethnicity within the United States.
OBJECTIVE
To investigate the race/ethnicity and sex-specific variations in proximal colon cancer survival within the United States.


BACKGROUND
Recent studies suggest a shift toward more proximal distributions of colon cancers. Survival benefits from screening colonoscopy may be limited to left-sided cancers. Identifying groups at greatest risk for mortality from proximal cancers will help to target health care resources to address these disparities.


METHODS
A retrospective cohort study from 1973 to 2004 using a large population-based cancer registry to investigate demographic variations in colon cancer survival.


RESULTS
Marked sex and race/ethnicity-specific variations in proximal colon cancer survival were observed. Overall 5-year survival was greatest in females (5-y survival, females: 44.5% and males: 41.7%, P<0.001) and in Asians (5-y survival, Asians: 50.4%, non-Hispanic whites: 43.1%, blacks: 39.7%, and Hispanics: 46.7%, P<0.001). Compared with females, males had significantly worse 5-year survival outcomes [odds ratios (OR), 0.77; 95% confidence intervals (CI), 0.75-0.79]. Compared with non-Hispanic whites, blacks had worse 5-year survival odds (OR, 0.74; 95% CI, 0.70-0.78) and Asians had better survival outcomes (OR, 1.16; 95% CI, 1.08-1.24).


CONCLUSIONS
There exists significant sex and race/ethnicity-specific disparities in 5-year survival from proximal colon cancer. These differences may be explained by variations in delivery of health care between demographic groups or differences in disease biology specific to each group.
Wong
Robert John
RJ
Department of Medicine, California Pacific Medical Center, San Francisco, CA 94115, USA. RobertWong123@gmail.com
D000328:Adult; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D012737:Sex Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology