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Racial Comparisons in Treatment of Rectal Adenocarcinoma and Survival in the Military Health System.
Eaglehouse, Yvonne L; Darmon, Sarah; Gage, Michele M; Shriver, Craig D; Zhu, Kangmin.
Afiliación
  • Eaglehouse YL; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
  • Darmon S; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.
  • Gage MM; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
  • Shriver CD; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland, USA.
  • Zhu K; Division of Surgical Oncology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
JNCI Cancer Spectr ; 2024 Aug 29.
Article en En | MEDLINE | ID: mdl-39208282
ABSTRACT

BACKGROUND:

Racial disparities in treatment and outcomes of rectal cancer have been attributed to patients' differential access to care. We aimed to study treatment and outcomes of rectal cancer in the equal access Military Health System (MHS) to better understand potential racial disparities.

METHODS:

We accessed the MilCanEpi database to study a cohort of patients aged 18 and older who were diagnosed with rectal adenocarcinoma between 1998 and 2014. Receipt of guideline recommended treatment per tumor stage, cancer recurrence, and all-cause death were compared between Non-Hispanic White and Black patients using multivariable regression models with associations expressed as odds (AORs) or hazard ratios (AHRs) and their 95% confidence intervals (CIs).

RESULTS:

The study included 171 Black and 845 White patients with rectal adenocarcinoma. Overall, there were no differences in receipt of guideline concordant treatment (AOR = 0.76, 95% CI = 0.45, 1.29), recurrence (AHR = 1.34, 95% CI = 0.85, 2.12), or survival (AHR = 1.08, 95% CI = 0.77, 1.54) for Black patients compared to White patients. However, Black patients aged <50 years at diagnosis (AOR = 0.34, 95% CI 0.13, 0.90) or with stage III or IV tumors (AOR = 0.28, 95% CI = 0.12, 0.64) were less likely to receive guideline recommended treatment than White patients in stratified analysis.

CONCLUSIONS:

In the equal access MHS, while there were no overall racial disparities in rectal cancer treatment or clinical outcomes between Black and White patients, disparities among those with early-onset or late-stage rectal cancers were noted. This suggests factors other than access to care may play a role in the observed disparities and warrants further research.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JNCI Cancer Spectr Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JNCI Cancer Spectr Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido