Disparities/Minority Health

Blacks have worse colorectal cancer survival rates than whites

Blacks have lower colorectal cancer (CRC) survival rates than whites, Asians, and Hispanics, according to a recent study of Medicare patients. Asians had a lower risk of dying than whites and Hispanics had a similar rate to that of whites. The researchers investigated the correlations between CRC survival rates and sociodemographic factors, tumor characteristics, diagnosis, treatment, and hospital characteristics. The greatest reduction in CRC-specific mortality differences between blacks and whites was associated with socioeconomic status (5 percent), followed by tumor characteristics (3 percent), treatment (2 percent), and coexisting illness (2 percent). The greatest reduction in mortality differences between Asians and whites was related to tumor characteristics (5 percent), followed by treatment (2 percent) and socioeconomic status (1 percent).

For blacks, poor survival may be caused by biologic features that contribute to aggressive tumor behavior or by inherited or acquired genetic abnormalities which may have an impact on response to therapy. Differences in tumor site distribution and genetics may explain the high survival rates observed among Asians. Relative to whites, Asians have higher rates of distal colon cancer, which is associated with a lower risk of mortality.

The researchers identified patients with CRC from the Surveillance, Epidemiology, and End Results Program (SEER)-Medicare linked database. The sixteen SEER registries used in the study included selected geographic areas covering approximately 25 percent of the U.S. population since 2000. Patient followup ranged from 3 to 13 years. The study was partly supported by the Agency for Healthcare Research and Quality (HS16743).

See "Racial disparities in colorectal cancer survival," by Arica White, Ph.D., Sally W. Vernon, Ph.D., Luisa Franzini, Ph.D., and Xianglin L. Du, M.D., Ph.D., in Cancer 116, p. 4622-4631, 2010.

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