Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler St, Houston, TX 77030, USA.
Cancer Treat Res Commun. 2022;32:100619. doi: 10.1016/j.ctarc.2022.100619. Epub 2022 Aug 6.
There were racial disparities in treatment and mortality among patients with colorectal cancer, but few studies incorporated information on hypertension and diabetes and their treatment status.
The study identified 101,250 patients from Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database in the United States who were diagnosed with colorectal cancer at age ≥65 years between 2007 and 2015 with follow-up to December 2016.
There were substantial racial and ethnic disparities in the prevalence of hypertension and diabetes in patients with colorectal cancer, in receiving chemotherapy and radiation therapy, and in receiving antihypertensive and antidiabetic treatment. Racial disparities in receiving these therapies remained significant in this large cohort of Medicare beneficiaries after stratifications by private health insurance status at the time of cancer diagnosis and by tumor stage. Non-Hispanic black patients had a significantly higher risk of all-cause mortality (hazard ratio: 1.07, 95% CI: 1.04-1.10), which remained significantly higher (1.05, 1.02-1.08) after adjusting for patient sociodemographics, tumor factors, comorbidity and treatments as compared to non-Hispanic white patients. The adjusted risk of colorectal cancer-specific mortality was also significantly higher (1.08, 1.04-1.12) between black and white patients.
There were substantial racial disparities in prevalence of hypertension and diabetes in men and women diagnosed with colorectal cancer and in receipt of chemotherapy, radiation therapy, antihypertensive and antidiabetic treatment. Black patients with colorectal cancer had a significantly higher risk of all-cause mortality and colorectal cancer-specific mortality than whites, even after adjusting for sociodemographic characteristics, tumor factors, comorbidity scores, and treatments.
在患有结直肠癌的患者中，存在治疗和死亡率方面的种族差异，但很少有研究纳入高血压和糖尿病及其治疗状况的信息。
本研究在美国监测、流行病学和最终结果（SEER）-医疗保险数据库中确定了 101250 名年龄≥65 岁的患者，这些患者在 2007 年至 2015 年间被诊断患有结直肠癌，并随访至 2016 年 12 月。
在患有结直肠癌的患者中，高血压和糖尿病的患病率、接受化疗和放疗以及接受抗高血压和抗糖尿病治疗方面，存在显著的种族和民族差异。在对诊断时的私人健康保险状况和肿瘤分期进行分层后，在这个大型医疗保险受益人群中，这些治疗方法的种族差异仍然显著。非西班牙裔黑人患者的全因死亡率风险显著更高（危险比：1.07，95%置信区间：1.04-1.10），与非西班牙裔白人患者相比，调整患者社会人口统计学、肿瘤因素、合并症和治疗后，该风险仍然显著更高（1.05，1.02-1.08）。黑人和白人患者之间，结直肠癌特异性死亡率的调整风险也显著更高（1.08，1.04-1.12）。
在被诊断患有结直肠癌的男性和女性以及接受化疗、放疗、抗高血压和抗糖尿病治疗的患者中，高血压和糖尿病的患病率存在显著的种族差异。与白人患者相比，患有结直肠癌的黑人患者的全因死亡率和结直肠癌特异性死亡率风险显著更高，即使在调整社会人口统计学特征、肿瘤因素、合并症评分和治疗后也是如此。
