Cooper G S, Yuan Z, Landefeld C S, Rimm A A
Division of Gastroenterology, University Hospitals of Cleveland, Cleveland, OH 44106, USA.
Am J Public Health. 1996 Apr;86(4):582-6. doi: 10.2105/ajph.86.4.582.
This study examined surgery for colorectal cancer among Medicare beneficiaries 65 years of age or older with an initial diagnosis in 1987 (n = 81 579). Black patients were less likely than White to undergo surgical resection (68% vs 78%), even after age, comorbidity, and location and extent of tumor were controlled for. Among those who underwent resection, Black patients were more likely to die (a 2-year mortality rate of 40.0% vs 33.5% in White patients); this disparity also remained after confounders had been controlled. The disparities were similar in teaching and nonteaching hospitals and in private and public hospitals. These data may indicate racially based differences among Medicare beneficiaries in access to and quality of care for colorectal cancer.
本研究调查了1987年首次确诊的65岁及以上医疗保险受益人的结直肠癌手术情况（n = 81579）。即便在对年龄、合并症以及肿瘤位置和范围进行控制之后，黑人患者接受手术切除的可能性仍低于白人患者（68%对78%）。在接受切除手术的患者中，黑人患者死亡的可能性更大（2年死亡率为40.0%，而白人患者为33.5%）；在对混杂因素进行控制之后，这种差异依然存在。教学医院和非教学医院以及私立和公立医院中的差异情况相似。这些数据可能表明医疗保险受益人在获得结直肠癌治疗的机会和治疗质量方面存在基于种族的差异。
