Differences in Colorectal Cancer Outcomes by Race and Insurance.
Differences in Colorectal Cancer Outcomes by Race and Insurance.
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DOI：
10.3390/ijerph13010048
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发表时间：
2015-12-22
影响因子：
--
通讯作者：
Brown CP
中科院分区：
文献类型：
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作者：
Tawk R;Abner A;Ashford A;Brown CP
结直肠癌（CRC）是非洲裔美国女性中第二常见的癌症，也是非洲裔美国男性中第三常见的癌症。与任何其他种族或族裔群体相比，非裔美国人的CRC死亡率最高。死亡率的差异很大程度上可能是由于在疾病的后期诊断，这可能是由于不平等的筛查。本研究的目的是确定种族和保险状况对CRC患者CRC结局的影响。数据来自监测、流行病学和最终结果数据库。Logistic回归模型用于检查在调整保险，种族和其他变量后接受治疗的几率。当将种族和保险与CRC相关死亡联系起来时，在调整社会人口学和肿瘤特征后，使用考克斯比例风险模型来测量CRC死亡的风险。黑人被诊断出的疾病比白人更晚期，死于结肠癌和直肠癌的风险也更高。缺乏保险与CRC相关死亡的增加有关。这项研究的结果可以帮助描述和针对CRC健康结果差异最大的患者。
Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The mortality rate from CRC is highest among African Americans compared to any other racial or ethnic group. Much of the disparity in mortality is likely due to diagnosis at later stages of the disease, which could result from unequal access to screening. The purpose of this study is to determine the impact of race and insurance status on CRC outcomes among CRC patients. Data were drawn from the Surveillance, Epidemiology, and End Results database. Logistic regressions models were used to examine the odds of receiving treatment after adjusting for insurance, race, and other variables. Cox proportional hazard models were used to measure the risk of CRC death after adjusting for sociodemographic and tumor characteristics when associating race and insurance with CRC-related death. Blacks were diagnosed at more advanced stages of disease than whites and had an increased risk of death from both colon and rectal cancers. Lacking insurance was associated with an increase in CRC related-deaths. Findings from this study could help profile and target patients with the greatest disparities in CRC health outcomes.