Health disparity in complicated colorectal cancer

Abstract

The purpose of this study was to assess for disparity within a cohort of patients presenting with complicated colorectal cancer. A retrospective study of 522 patients who underwent surgery for colorectal cancer at a tertiary care institution was performed. Complicated cancer was defined by perforating or obstructing colonic lesions. Statistical analysis was conducted by chi2 test and analysis of variance. Of the 522 patients, 72 patients (14%) presented with complicated colorectal cancer. Blacks in low-income brackets (36 vs 0%, P < 0.001) and those with public insurance (55 vs 16%, P < 0.05) had increased presentation with complicated colorectal cancers as compared with whites. Black (91%) and Hispanic women (86%), when compared with white women (37%) had increased incidence of complicated colorectal cancer (P < 0.05). Patients in low-income brackets, regardless of race, had increased cancer recurrence rates (57 vs 8%, P < 0.001) compared with patients in average or high-income brackets. Mortality rate was 57 per cent in Hispanic, 29 per cent in white, and 27 per cent in black patients (P = nonsignificant). Specific targeting of colorectal cancer screening, education, and follow-up programs is imperative for minority women and patients of low socioeconomic status.