Moten Ambria S, Taylor George A, Fagenson Alexander M, Poggio Juan Lucas, Philp Matthew M, Lau Kwan N
Division of Surgical Oncology, Department of Surgery, University of Tennessee Health Science Center, 875 Monroe Ave, Memphis, TN 38163, USA.
Department of Surgery, Temple University Hospital, 3401 N Broad St, Philadelphia, PA 19140, USA.
Surg Pract Sci. 2023 Apr 12;13:100166. doi: 10.1016/j.sipas.2023.100166. eCollection 2023 Jun.
Prior research has demonstrated racial disparities in the treatment of colon cancer. We sought to determine if treatment disparities persist.
Patients with colon adenocarcinoma diagnosed from 2012 to 2016 were identified using the Surveillance, Epidemiology and End Results database. Associations between race and clinical characteristics were assessed using Chi square tests. The likelihood of receiving treatment based on race was assessed using logistic regression.
Of 18,841 patients, 69.7% were White, 10.2% Black, 8.7% Hispanic and 11.4% Asian. Among patients with early-stage disease (stage I or II), 96.1% of Whites, 94.6% of Blacks, 95.6% of Hispanics and 97.7% of Asians underwent surgery (p = 0.01), while 8.9% of Whites, 9.3% of Blacks, 12.4% of Hispanics and 8.9% of Asians received chemotherapy (p = 0.03). For years 2012 to 2016 collectively, Blacks with early-stage disease were less likely than Whites to undergo any surgery (aOR = 0.54; 95% CI: 0.36 - 0.81) and more likely to receive neither surgery nor chemotherapy (aOR = 1.91; 95% CI: 1.25 - 2.93). However, when assessing each year individually, the most recent years revealed no difference in the likelihood of receiving surgery in (aOR = 0.45; 95% CI: 0.16 - 1.29 in 2016) or receiving neither surgery nor chemotherapy (aOR = 2.17; 95% CI: 0.70 - 6.70 in 2016).
Racial disparities in the treatment of colon adenocarcinoma have improved in recent years. Health care providers must continue to provide equitable, evidence-based care to ensure that treatment disparities are eliminated.
先前的研究已证明在结肠癌治疗方面存在种族差异。我们试图确定治疗差异是否仍然存在。
使用监测、流行病学和最终结果数据库识别出2012年至2016年期间诊断为结肠腺癌的患者。使用卡方检验评估种族与临床特征之间的关联。使用逻辑回归评估基于种族接受治疗的可能性。
在18841名患者中，69.7%为白人，10.2%为黑人，8.7%为西班牙裔，11.4%为亚裔。在早期疾病（I期或II期）患者中，96.1%的白人、94.6%的黑人、95.6%的西班牙裔和97.7%的亚裔接受了手术（p = 0.01），而8.9%的白人、9.3%的黑人、12.4%的西班牙裔和8.9%的亚裔接受了化疗（p = 0.03）。总体而言，2012年至2016年期间，患有早期疾病的黑人比白人接受任何手术的可能性更小（调整后比值比[aOR]=0.54；95%置信区间[CI]：0.36 - 0.81），且更有可能既不接受手术也不接受化疗（aOR = 1.91；95% CI：1.25 - 2.93）。然而，当单独评估每年的情况时，最近几年显示在接受手术的可能性方面没有差异（2016年aOR = 0.45；95% CI：0.16 - 1.29），在既不接受手术也不接受化疗的可能性方面也没有差异（2016年aOR = 2.17；95% CI：0.70 - 6.70）。
近年来结肠腺癌治疗中的种族差异有所改善。医疗保健提供者必须继续提供公平、基于证据的护理，以确保消除治疗差异。
