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. 2010 Oct;100(10):1912-6.
doi: 10.2105/AJPH.2009.184192. Epub 2010 Aug 19.

Racial disparities in stage-specific colorectal cancer mortality: 1960-2005

Samir Soneji  1 , Shally Shalini Iyer, Katrina Armstrong, David A Asch
Affiliations

Racial disparities in stage-specific colorectal cancer mortality: 1960-2005

Samir Soneji et al. Am J Public Health. 2010 Oct.

Abstract

Objectives: We examined whether racial disparities in stage-specific colorectal cancer survival changed between 1960 and 2005.

Methods: We used US Mortality Multiple-Cause-of-Death Data Files and intercensal estimates to calculate standardized mortality rates by gender and race from 1960 to 2005. We used Surveillance, Epidemiology, and End Results (SEER) data to estimate stage-specific colorectal cancer survival. To account for SEER sampling uncertainty, we used a bootstrap resampling procedure and fit a Cox proportional hazards model.

Results: Between 1960-2005, patterns of decline in mortality rate as a result of colorectal cancer differed greatly by gender and race: 54% reduction for White women, 14% reduction for Black women, 39% reduction for White men, and 28% increase for Black men. Blacks consistently experienced worse rates of stage-specific survival and life expectancy than did Whites for both genders, across all age groups, and for localized, regional, and distant stages of the disease.

Conclusions: The rates of stage-specific colorectal cancer survival differed among Blacks when compared with Whites during the 4-decade study period. Differences in stage-specific life expectancy were the result of differences in access to care or quality of care. More attention should be given to racial disparities in colorectal cancer management.

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Figures

FIGURE 1
FIGURE 1
Overall standardized colorectal cancer death rate for (a) women and (b) men: US Mortality Data Files and US intercensal estimates, 1960–2005.
FIGURE 2
FIGURE 2
Observed stage-specific survival of women aged 60–64 years, by race, for (a) localized cancer, (b) regional cancer, and (c) distant cancer: National Cancer Institute Surveillance, Epidemiology, and End Results database, 1990–1999.
FIGURE 3
FIGURE 3
Excess stage-specific colorectal cancer mortality over 4 decades among Blacks: 1970–2000. Note. The 95% bootstrap confidence interval is shown as a vertical line, and the point estimate is shown as an open circle.
FIGURE 4
FIGURE 4
Estimated life expectancy at age 60, by race and gender: 1970–2000. Note. The 95% bootstrap confidence interval is shown as a vertical line. The point estimate is shown as an open circle for men and an open triangle for women. Death may occur from colorectal cancer or any other cause. The vertical scale of life expectancy differs by stage at diagnosis.
See this image and copyright information in PMC

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