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Socioeconomic Status and Co-Morbidities Have
Significant Impact on Survival of Colorectal
Cancer Among Blacks
Newswise — Blacks are surviving colorectal
cancer at a significantly lower rate
compared to whites and Asians due to
co-morbidities and their socioeconomic
status, according to research by
epidemiologists at The University of Texas
Health Science Center at Houston (UTHealth).
Among the ethnic groups examined, Asians had
the lowest risk of death. Whites had a 26
percent higher risk and blacks had a 56
percent higher risk of death compared to
Asians. Socioeconomic status had the most
significant impact on the survival rates of
the three groups.
The research is published in the July issue
of Cancer, a peer-reviewed journal of the
American Cancer Society (ACS).
“Co-morbidities and socioeconomic status
appear to be important factors contributing
to blacks’ poorer survival relative to
whites and Asians. However, substantial
racial disparities in survival persisted,”
said lead author Arica White, Ph.D., M.P.H.,
former doctoral student at The University of
Texas School of Public Health, part of
UTHealth.
“The results from this study will inform our
progress toward eliminating health
disparities and reducing the number of
deaths from colorectal cancer.”
Colorectal cancer is the third most
frequently diagnosed non-skin cancer in men
and women in the United States, according to
the ACS.
The risk of developing colorectal cancer is
slightly higher in men than in women. ACS,
which estimates that 51,000 Americans will
die from colorectal cancer this year,
recommends regular colorectal cancer
screening or testing among the most
important ways to prevent colorectal cancer.
According to White, this is the first study
which compares factors that contribute to
colorectal cancer survival differences
between whites and other racial groups and
between Asians and other racial groups.
Also collaborating on the study were
UTHealth School of Public Health researchers
Sally W. Vernon, Ph.D., director of the
Division of Health Promotion and Behavioral
Sciences; Luisa Franzini, Ph.D., associate
professor of management, policy and
community health; and Xianglin L. Du, M.D.,
Ph.D., associate professor of epidemiology.
The study included more than 37,000 Medicare
beneficiaries from across the United States
who had been diagnosed with stages I to III
colorectal cancer from 1992 to 2002.
Investigators examined racial disparities in
surviving colorectal cancer among whites,
blacks and Asians based on differences in
sociodemographic factors, tumor
characteristics, stage at diagnosis,
treatment and hospital characteristics.
“This research also sets the stage for
future research to further examine the role
of socioeconomic status and co-morbidities
as well as other factors that have
previously not been examined,” said White.
Some of the factors such as tumor
characteristics and treatment appeared to
substantially reduce the mortality
difference between whites and blacks but did
not have an impact on the mortality
difference between Asians and blacks.
Lifestyle differences may also explain some
of the dissimilarities in survival,
according to White. Previous studies have
revealed that obese patients have a 50
percent increased risk of developing colon
cancer and a 30 percent higher risk of dying
from the disease.
White noted that future research should
examine the role of other factors such as
quality of care, particularly treatment and
post-treatment surveillance. White is
currently an Epidemic Intelligence Service
Officer at The Centers for Disease Control
and Prevention.
Funding for this research was provided
through a grant from the National Cancer
Institute.
