Colorectal cancer rates in African Americans equal with insurance parity

ere essentially the same for both blacks and whites in the VA system. Since most study participants were male, the findings may be limited in their applicability to the general population.

"Studies of Medicare recipients alone have shown that this racial disparity persists, but to this point no one has looked at [patients with combined Medicare and Medicaid coverage]," Smalley said. "So what makes this study unique is that everybody in the study has exactly the same insurance status."

The researchers reviewed the medical records of 949 elderly patients diagnosed with colon or rectal cancer between 1984 and 1992. They tracked the patients' progress through 1999.

All were Medicare and Medicaid patients from the beginning of their illness throughout the study.

"These patients were civilians from every county in Tennessee," said Smalley, making the study more generalized to a wider population than if conducted at a single medical center.

"The bottom line is, we found that there were no racial differences in survival," Smalley said. "There were subtle differences in how patients were treated. For example, whites were slightly more likely than blacks to receive surgical therapy, and blacks were more likely to be treated with radiation therapy for rectal cancer.

"Our contention is that while there may be biological differences between African-Americans and whites and we know that there are differences in how they are treated, the fact is that we are likely to overcome a lot of those differences if everyone has equal access to care."

The primary author of the study, Selwyn Rogers Jr., M.D., formerly at Meharry Medical College, added, "these findings argue that the processes of care may be similar for patients with identical insurance."

Rogers, an assistant professor of Surgery at Harvard Medical School and section chief of Trauma, Burns, and Surgical Critical Care at the Brigham and Women's Hosp

Contact: Clinton Colmenaers
Vanderbilt University Medical Center

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