title: Differences in Colorectal Cancer Outcomes by Race and Insurance.
abstract: Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of the disparity in mortality is likely due to diagnosis at later stages of the disease, which could result from unequal access to screening. The purpose of this study is to determine the impact of race and insurance status on CRC outcomes among CRC patients. Data were drawn from the Surveillance, Epidemiology, and End Results database. Logistic regressions models were used to examine the odds of receiving treatment after adjusting for insurance, race, and other variables. Cox proportional hazard models were used to measure the risk of CRC death after adjusting for sociodemographic and tumor characteristics when associating race and insurance with CRC-related death. Blacks were diagnosed at more advanced stages of disease than whites and had an increased risk of death from both colon and rectal cancers. Lacking insurance was associated with an increase in CRC related-deaths. Findings from this study could help profile and target patients with the greatest disparities in CRC health outcomes.
authors.affiliation: Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&amp;M University, Tallahassee, FL 32307, USA. rima.tawk@famu.edu.
authors.forename: Rima
authors.initials: R
authors.lastname: Tawk
authors.affiliation: Residential Services Administrator, Marianna, FL 32448, USA. a_abner21@yahoo.com.
authors.forename: Adrian
authors.initials: A
authors.lastname: Abner
authors.affiliation: Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&amp;M University, Tallahassee, FL 32307, USA. alicestine.ashford@famu.edu.
authors.forename: Alicestine
authors.initials: A
authors.lastname: Ashford
authors.affiliation: Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, Florida A&amp;M University, Tallahassee, FL 32307, USA. perry.brown@famu.edu.
authors.forename: Clyde Perry
authors.initials: CP
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000401:mortality*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012737:Sex Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: access to care; colorectal health; health disparities; social determinants of health