Racial disparities in stage-specific colorectal cancer mortality: 1960-2005.
OBJECTIVE
We examined whether racial disparities in stage-specific colorectal cancer survival changed between 1960 and 2005.


METHODS
We used US Mortality Multiple-Cause-of-Death Data Files and intercensal estimates to calculate standardized mortality rates by gender and race from 1960 to 2005. We used Surveillance, Epidemiology, and End Results (SEER) data to estimate stage-specific colorectal cancer survival. To account for SEER sampling uncertainty, we used a bootstrap resampling procedure and fit a Cox proportional hazards model.


RESULTS
Between 1960-2005, patterns of decline in mortality rate as a result of colorectal cancer differed greatly by gender and race: 54% reduction for White women, 14% reduction for Black women, 39% reduction for White men, and 28% increase for Black men. Blacks consistently experienced worse rates of stage-specific survival and life expectancy than did Whites for both genders, across all age groups, and for localized, regional, and distant stages of the disease.


CONCLUSIONS
The rates of stage-specific colorectal cancer survival differed among Blacks when compared with Whites during the 4-decade study period. Differences in stage-specific life expectancy were the result of differences in access to care or quality of care. More attention should be given to racial disparities in colorectal cancer management.
Soneji
Samir
S
Robert Wood Johnson Health & Society Scholars Program, University of Pennsylvania, Philadelphia, PA 19104, USA. soneji@wharton.upenn.edu
Iyer
Shally Shalini
SS
Armstrong
Katrina
K
Asch
David A
DA
D001741:Black or African American; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D018426:SEER Program; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D044465:White People