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Colorectal cancer rates in African Americans equal with insurance parity

A collaborative project between researchers at Vanderbilt University Medical Center and Meharry Medical College found that when insurance coverage is equal, racial differences in deaths due to colorectal cancer in blacks and whites disappear.

The new study, which appears in the March issue of Cancer Causes and Control, examined the effect of race on colorectal cancer outcomes in elderly Tennesseans with identical health care coverage and provided some revealing results.

The colon cancer death rate in blacks is disproportionately higher than in whites. These disparities prevail even when factors like age, gender, stage of cancer, and geography are taken into consideration.

"In many, if not all cancers, there are racial disparities in survival," said Walter Smalley, M.D., associate professor of Medicine at Vanderbilt University Medical Center and section chief of Gastroenterology at the Nashville Veteran's Administration Medical Center. "Colon cancer, which is the No. 2 cancer killer in America, is no exception."

Several previous studies have demonstrated a racial difference in colon cancer survival. A 1998 study from the Surveillance Epidemiology End Results program found that the five-year survival rate for patients with localized colorectal cancer (stages 1 and 2) in whites was 90 percent compared to 83 percent for blacks.

For patients with a regional spread of the cancer (stages 3 and 4), survival statistics were similarly disproportionate: 65 percent in whites and 53 percent in blacks. Studies of Medicare recipients have also demonstrated the survival disparity, but the level of care among those patients is highly variable, making interpretation difficult.

One of the first indications that the disparity could be countered by equal access to health care came from a nationwide study of colon cancer patients treated at VA Medical Centers. The study found that both the processes of care and overall survival w
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Contact: Clinton Colmenaers
clinton.colmenares@vanderbilt.edu
615-322-4747
Vanderbilt University Medical Center
19-Apr-2004


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