Age-, race-, and ethnicity-related differences in the treatment of nonmetastatic rectal cancer: a patterns of care study from the national cancer data base

Annals of Surgical Oncology
Nestor F EsnaolaMiguel A Rodriguez-Bigas

Abstract

Recent studies suggest that older patients and minorities are less likely to receive surgical and adjuvant therapy for rectal cancer. We analyzed the independent effect of age and race/ethnicity on treatment for rectal cancer controlling for comorbidity and socioeconomic status using a nationwide sample We identified 35,695 patients with rectal adenocarcinoma diagnosed between 2003 and 2005 using the National Cancer Data Base. Comorbidity was calculated from medical records and administrative data. Educational level and income were estimated from census data. Characteristics were compared across groups by chi(2) tests. Odds ratios of surgical and adjuvant therapy and 95% confidence intervals were calculated by logistic regression. A total of 51% of patients were age > or =65, 8.7% were African American, and 4.9% were Hispanic. Younger patients, African Americans, and Hispanics were more likely to present with advanced disease compared with older, white patients (P < .001). Age > or =65 was associated with underuse of surgery and adjuvant therapy (P < .001). Only 85.1% of African Americans were resected, compared with 90.7% of whites (adjusted odds ratio, .62; 95% confidence interval, .54-.71). Among resected patients, race/ethn...Continue Reading

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