A black-white comparison of the quality of stage-specific colon cancer treatment

Jamillah Berry, Lee Caplan, Sharon Davis, Patrick Minor, Margaret Counts-Spriggs, Roni Glover, Vickie Ogunlade, Kevin Bumpers, John Kauh, Otis W. Brawley, Christopher Flowers

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)713-722
Number of pages10
JournalCancer
Volume116
Issue number3
DOIs
StatePublished - Feb 1 2010

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Keywords

  • Blacks
  • Colon adenocarcinoma
  • Diagnostic stage
  • Disparities
  • Quality of care

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Berry, J., Caplan, L., Davis, S., Minor, P., Counts-Spriggs, M., Glover, R., Ogunlade, V., Bumpers, K., Kauh, J., Brawley, O. W., & Flowers, C. (2010). A black-white comparison of the quality of stage-specific colon cancer treatment. Cancer, 116(3), 713-722. https://doi.org/10.1002/cncr.24757