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Details

Autor(en) / Beteiligte
Titel
A black‐white comparison of the quality of stage‐specific colon cancer treatment
Ist Teil von
  • Cancer, 2010-02, Vol.116 (3), p.713-722
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2010
Quelle
MEDLINE
Beschreibungen/Notizen
  • BACKGROUND: Several studies have attributed racial disparities in cancer incidence and mortality to variances in socioeconomic status and health insurance coverage. However, an Institute of Medicine report found that blacks received lower quality care than whites after controlling for health insurance, income, and disease severity. METHODS: To examine the effects of race on colorectal cancer outcomes within a single setting, the authors performed a retrospective cohort study that analyzed the cancer registry, billing, and medical records of 365 university hospital patients (175 blacks and 190 whites) diagnosed with stage II‐IV colon cancer between 2000 and 2005. Racial differences in the quality (effectiveness and timeliness) of stage‐specific colon cancer treatment (colectomy and chemotherapy) were examined after adjusting for socioeconomic status, health insurance coverage, sex, age, and marital status. RESULTS: Blacks and whites had similar sociodemographic characteristics, tumor stage and site, quality of care, and health outcomes. Age and diagnostic stage were predictors of quality of care and mortality. Although few patients (5.8%) were uninsured, they were more likely to present at advanced stages (61.9% at stage IV) and die (76.2%) than privately insured and publicly insured patients (p = .002). CONCLUSIONS: In a population without racial differences in socioeconomic status or insurance coverage, patients receive the same quality of care, regardless of racial distinction, and have similar health outcomes. Age, diagnostic stage, and health insurance coverage remained independently associated with mortality. Future studies of disparities in colon cancer treatment should examine sociocultural barriers to accessing appropriate care in various healthcare settings. Cancer 2010. © 2009 American Cancer Society. The sociodemographic characteristics and stage‐specific quality of care (effectiveness and timeliness) of blacks were similar to those of whites in a retrospective study of billing, medical, and cancer registry records of 365 university hospital patients (175 blacks and 190 whites) diagnosed with stage II‐IV colon cancer between 2000 and 2005. There were no significant racial differences in mortality, although age, diagnostic stage, and health insurance coverage were independently associated.

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