Abstract
Abstract only
528
Background: A racial/ethnic difference in colon cancer survival has been described in literature. However the reasons for this are unclear and access to health care is one of the factors that have been implicated. We plan to examine the clinicopathologic factors of Caucasians (CA) and African Americans (AA) in an equal to access health care system.
Methods: 21,992 patients from 1995 to 2009 were identified from the VA Central Cancer Registry database. Age, race, stage, histology, lymph node status, and type of treatment received data were collected.
Results: Out of 21,992 patients, 17,924 were CA and 4,068 were AA. 98.07% of CA and 97.83% of all AA were males. Pathological T stages were as follows: T1 = 15.58% vs. 16.13%, T2 = 18.81% vs. 17.56%, T3 = 55.48% vs. 56.03%, T4 = 10.13% vs. 10.28% for CA and AA respectively. Stage-specific incidence, histological grades, and lymph nodal involvement rates were similar in both groups. 77.16% of CA and 77.03% of all AA received chemotherapy. 82.07% of CA and 78.78% of all AA underwent surgery. Median overall survival in CA was 30.73 months and in AA it was 27 months (p < 0.0001). Stage-specific survival (in months) was significantly better for CA in early-stage disease (p < 0.0001) but is similar for both races in metastatic disease (see Table). Median survival in male and female sex irrespective of race was 29.867 months and 35.667 months respectively.
Conclusions: Overall survival is better in CA when compared to AA in an equal to access health care system. This survival difference was present only in early-stage disease while in metastatic disease the survival was uniformly poor. Incidence as per stage, lymph node status,and grade were not significantly different among AA and CA. Tumor biology and post-treatment surveillance are potential factors and this needs to be investigated further.
[Table: see text]
No significant financial relationships to disclose.