Assessing short- and long-term outcomes among black vs white Medicare patients undergoing resection of colorectal cancer

Eric B. Schneider, Adil H. Haider, Omar Hyder, Jonathan E. Efron, Anne O. Lidor, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background: We sought to identify differences among black and white Medicare-insured patients with colorectal cancer who underwent resection. Methods: Surveillance, Epidemiology and End Results-Medicare (SEER-Medicare) linked inpatient data from 1986 to 2005 were examined. Differences in short- and long-term outcomes among black vs white patients were investigated. Results: There were 125,676 (92.4%) white and 9,891 (7.6%) black patients who met the criteria. Black patients were younger (75.5 vs 77.2 years; P <.001) but had more comorbidities than did white patients (mean Charlson comorbidity index score 3.99 vs 3.87; P <.001). Black patients demonstrated greater odds of in-hospital mortality (odds ratio [OR], 1.43; 95% confidence interval [CI], 1.30 to 1.56) and readmission within 30 days (OR, 1.26; 95% CI, 1.18 to 1.34). Comparing 1986 to 1990 vs 2001 to 2005, black patients had greater odds of 30-day readmission (OR, 1.12 vs 1.31) but reduced odds of index in-hospital mortality (OR, 1.84 vs 1.28). Black patients had worse long-term survival after colorectal surgery (hazard ratio [HR], 1.21; 95% CI, 1.17 to 1.25; P <.001). Conclusions: Black patients with colorectal cancer demonstrated increased risk of mortality and readmission after controlling for age, sex, and comorbidities. Although black vs white differences in perioperative mortality decreased over time, disparities in readmission and long-term survival persisted.

Original languageEnglish (US)
Pages (from-to)402-408
Number of pages7
JournalAmerican journal of surgery
Volume205
Issue number4
DOIs
StatePublished - Apr 1 2013

Keywords

  • Colorectal cancer
  • Disparities
  • Race
  • SEER-Medicare

ASJC Scopus subject areas

  • Surgery

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