Disparities in treatment and survival of white and native American patients with colorectal cancer

A SEER analysis

Cristina V. Cueto, Sean Szeja, Betsy C. Wertheim, Evan S. Ong, Vassiliki Tsikitis

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

BACKGROUND: Minority groups with colorectal cancer have not experienced the decline in incidence and mortality that has been reported in whites.We sought to determine whether differences exist in treatment and survival between white and Native American patients with colorectal cancer because little has been written about this specific minority group. STUDY DESIGN: The Surveillance Epidemiology and End Results (SEER) database for colorectal cancer was used to compare treatment and survival in whites (colon, n = 137,949; rectum, n = 46,843) and Native Americans (colon, n = 872; rectum, n = 316). Cox proportional hazards models were used to compare cancer-specific survival in Native Americans with whites, adjusted for stage, sex, age and year of diagnosis, socioeconomic status, and treatment. RESULTS: Native Americans presented at younger ages than whites for both colon and rectal cancer (p <0.001). They were diagnosed at more advanced stages of disease than whites for only colon cancer. No significant differences were detected in the proportion of patients recommended for surgery between the two groups, for either cancer at any stage (all p > 0.05). Native Americans with rectal cancer were more likely to receive radiation than whites (p <0.001), but they received less sphincter-preserving surgery (60.0% vs 65.4%; p=0.045).Native Americans with colon cancer fared significantly worse than whites (hazard ratio = 1.20; 95% CI = 1.08 to 1.34), but there is no difference in cancer-free survival between races for rectal cancer. CONCLUSIONS: Compared with whites, Native Americans with colon cancer have worse cancer-specific survival.

Original languageEnglish (US)
Pages (from-to)469-474
Number of pages6
JournalJournal of the American College of Surgeons
Volume213
Issue number4
DOIs
StatePublished - Oct 2011
Externally publishedYes

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North American Indians
Colorectal Neoplasms
Epidemiology
Survival
Rectal Neoplasms
Colonic Neoplasms
Minority Groups
Rectum
Therapeutics
Colon
Neoplasms
Proportional Hazards Models
Social Class
Databases
Radiation
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Disparities in treatment and survival of white and native American patients with colorectal cancer : A SEER analysis. / Cueto, Cristina V.; Szeja, Sean; Wertheim, Betsy C.; Ong, Evan S.; Tsikitis, Vassiliki.

In: Journal of the American College of Surgeons, Vol. 213, No. 4, 10.2011, p. 469-474.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Minority groups with colorectal cancer have not experienced the decline in incidence and mortality that has been reported in whites.We sought to determine whether differences exist in treatment and survival between white and Native American patients with colorectal cancer because little has been written about this specific minority group. STUDY DESIGN: The Surveillance Epidemiology and End Results (SEER) database for colorectal cancer was used to compare treatment and survival in whites (colon, n = 137,949; rectum, n = 46,843) and Native Americans (colon, n = 872; rectum, n = 316). Cox proportional hazards models were used to compare cancer-specific survival in Native Americans with whites, adjusted for stage, sex, age and year of diagnosis, socioeconomic status, and treatment. RESULTS: Native Americans presented at younger ages than whites for both colon and rectal cancer (p <0.001). They were diagnosed at more advanced stages of disease than whites for only colon cancer. No significant differences were detected in the proportion of patients recommended for surgery between the two groups, for either cancer at any stage (all p > 0.05). Native Americans with rectal cancer were more likely to receive radiation than whites (p <0.001), but they received less sphincter-preserving surgery (60.0{\%} vs 65.4{\%}; p=0.045).Native Americans with colon cancer fared significantly worse than whites (hazard ratio = 1.20; 95{\%} CI = 1.08 to 1.34), but there is no difference in cancer-free survival between races for rectal cancer. CONCLUSIONS: Compared with whites, Native Americans with colon cancer have worse cancer-specific survival.",
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N2 - BACKGROUND: Minority groups with colorectal cancer have not experienced the decline in incidence and mortality that has been reported in whites.We sought to determine whether differences exist in treatment and survival between white and Native American patients with colorectal cancer because little has been written about this specific minority group. STUDY DESIGN: The Surveillance Epidemiology and End Results (SEER) database for colorectal cancer was used to compare treatment and survival in whites (colon, n = 137,949; rectum, n = 46,843) and Native Americans (colon, n = 872; rectum, n = 316). Cox proportional hazards models were used to compare cancer-specific survival in Native Americans with whites, adjusted for stage, sex, age and year of diagnosis, socioeconomic status, and treatment. RESULTS: Native Americans presented at younger ages than whites for both colon and rectal cancer (p <0.001). They were diagnosed at more advanced stages of disease than whites for only colon cancer. No significant differences were detected in the proportion of patients recommended for surgery between the two groups, for either cancer at any stage (all p > 0.05). Native Americans with rectal cancer were more likely to receive radiation than whites (p <0.001), but they received less sphincter-preserving surgery (60.0% vs 65.4%; p=0.045).Native Americans with colon cancer fared significantly worse than whites (hazard ratio = 1.20; 95% CI = 1.08 to 1.34), but there is no difference in cancer-free survival between races for rectal cancer. CONCLUSIONS: Compared with whites, Native Americans with colon cancer have worse cancer-specific survival.

AB - BACKGROUND: Minority groups with colorectal cancer have not experienced the decline in incidence and mortality that has been reported in whites.We sought to determine whether differences exist in treatment and survival between white and Native American patients with colorectal cancer because little has been written about this specific minority group. STUDY DESIGN: The Surveillance Epidemiology and End Results (SEER) database for colorectal cancer was used to compare treatment and survival in whites (colon, n = 137,949; rectum, n = 46,843) and Native Americans (colon, n = 872; rectum, n = 316). Cox proportional hazards models were used to compare cancer-specific survival in Native Americans with whites, adjusted for stage, sex, age and year of diagnosis, socioeconomic status, and treatment. RESULTS: Native Americans presented at younger ages than whites for both colon and rectal cancer (p <0.001). They were diagnosed at more advanced stages of disease than whites for only colon cancer. No significant differences were detected in the proportion of patients recommended for surgery between the two groups, for either cancer at any stage (all p > 0.05). Native Americans with rectal cancer were more likely to receive radiation than whites (p <0.001), but they received less sphincter-preserving surgery (60.0% vs 65.4%; p=0.045).Native Americans with colon cancer fared significantly worse than whites (hazard ratio = 1.20; 95% CI = 1.08 to 1.34), but there is no difference in cancer-free survival between races for rectal cancer. CONCLUSIONS: Compared with whites, Native Americans with colon cancer have worse cancer-specific survival.

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