title: Age-Related Treatment Disparities among Medicaid Beneficiaries with Metastatic Colorectal Cancer.
abstract: OBJECTIVE
  To evaluate the impact of age on receipt of chemotherapy among low-income individuals with metastatic colorectal cancer.
  
  
  METHODS
  North Carolina Medicaid enrollees with metastatic colorectal cancer diagnosed from 1999 to 2002 with colorectal as their only cancer (N=326).
  
  
  METHODS
  Retrospective analysis using linked data from the North Carolina Cancer Registry and Medicaid claims.
  
  
  METHODS
  Outcomes were chemotherapy use within one year of diagnosis and time to initiation of chemotherapy. Cox regression models were fit to evaluate the association between chemotherapy use and age, stratifying for comorbidity, and adjusting for patient, community, and health services characteristics.
  
  
  RESULTS
  Compared to 67.4% of patients aged <70 years, only 26.2% of patients ≥70 years received chemotherapy. After adjustment, younger patients with and without comorbidity were more likely to receive chemotherapy than older patients (hazard ratio (HR)=2.27, 95% confidence interval (CI) 1.41-3.66 and HR=6.33, 95% CI 2.87-13.96, respectively). Among those who received chemotherapy, the median time to receipt was 53 days, and did not differ significantly by age or comorbidity.
  
  
  CONCLUSIONS
  In this low-income cohort, older age was consistently associated with non-receipt of chemotherapy but not longer time to initiation of chemotherapy regardless of comorbidity status.
authors: Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Heidi D
authors: HD
authors: Klepin
authors: Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Janet A
authors: JA
authors: Tooze
authors: Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors: Eun-Young
authors: EY
authors: Song
authors: National Cancer Institute, Rockville, North Carolina, USA.
authors: Ann M
authors: AM
authors: Geiger
authors: Davidson College, Davidson, North Carolina, USA.
authors: Kristie L
authors: KL
authors: Foley
keywords: Chemotherapy; Colon cancer; Comorbidity; Medicaid; Metastatic