title: Gender differences in colon cancer treatment.
abstract: Abstract Background: Despite women suffering a disproportionate burden of colon cancer mortality, few studies have examined gender differences in evidence-based treatment, especially in poorer states like Alabama.
  
  
  OBJECTIVE
  To describe colon cancer treatment in older patients diagnosed in Alabama by gender.
  
  
  METHODS
  Colon cancer patients 65 years and older diagnosed in 2000-2002 were identified from the Alabama Statewide Cancer Registry (N=1785). Treatment was identified from Medicare claims for 1999-2003. Outcomes were (1) receipt of surgery and adjuvant 5-fluorouracil chemotherapy (5FU) and (2) 5FU treatment duration (0-4, 5-7, and >7 months). Generalized Estimating Equation (GEE) models were used to determine significant gender differences, adjusting for clustering at the reporting hospital level, and controlling for race, age, stage, comorbid conditions, census tract-level socioeconomic variables, and adverse chemotherapy effects (when analyzing 5FU duration).
  
  
  RESULTS
  Overall, 93.9% of the patients received surgery. Of stage II-III patients undergoing surgery, 60.4% stage III and 25.6% stage II patients received 5FU. Compared with men, women were more likely to have surgery (95.5% vs. 92.2%, p=0.003), less likely to have 5FU (38.6% vs. 45.2%, p=0.02), and more likely to have 0-4 months of 5FU (32.9% vs. 24.9%, p=0.05). Gender differences were significant for having chemotherapy (adjusted odds ratio [aOR] 0.78, confidence interval [CI] 0.61-1.00, p=0.049), but not for having 0-4 months of 5FU when adjusting for adverse effects (aOR 1.36, CI 0.95-1.94, p=0.09).
  
  
  CONCLUSIONS
  In Alabama, some gender differences in stage-specific colon cancer treatment are worth further scrutiny.
authors.affiliation: Capstone College of Nursing, University of Alabama, Tuscaloosa, AL 35205, USA.
authors.forename: JoAnn S
authors.initials: JS
authors.lastname: Oliver
authors.forename: Michelle Y
authors.initials: MY
authors.lastname: Martin
authors.forename: Lisa
authors.initials: L
authors.lastname: Richardson
authors.forename: Young
authors.initials: Y
authors.lastname: Kim
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
mesh_terms: D000368:Aged; D000407:Alabama / Q000453:epidemiology; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D012042:Registries; D012737:Sex Factors; D014481:United States