Daniel R. Simpson|Mar??a Elena Mart??nez|Samir Gupta|Jona A. Hattangadi?Gluth|Loren K. Mell|Gregory M. Heestand|Paul T. Fanta|Sonia Ramamoorthy|Quynh?Thu Le|James D. Murphy
Racial Disparity in Consultation, Treatment, and the Impact on Survival in Metastatic Colorectal Cancer
University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|Stanford University|VA San Diego Healthcare System|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego|VA San Diego Healthcare System|Stanford University|University of California, San Diego
black patients metastatic colorectal cancer inferior survival compared white patients purpose study examine disparity specialist consultation multimodality treatment impact treatment inequality survivalwe identified 9935 nonhispanic white 1281 black patients stage iv colorectal cancer aged 66 years older surveillance epidemiology end results seermedicare linked database logistic regression models identified racebased differences consultation rates subsequent treatment surgery chemotherapy radiation multivariable cox regression models identified potential factors explain racebased survival differences statistical tests twosidedblack patients lower rates consultation surgery medical oncology radiation oncology among patients seen consultation black patients received less surgery directed primary tumor liver lungdirected surgery chemotherapy radiotherapy unadjusted survival analysis found 15 higher chance dying black patients compared white patients hazard ratio hr 115 95 confidence interval ci 108 122 p 001 adjustment patient tumor demographic variables marginally reduced risk death hr 108 95 ci 101 115 p 03 adjustment differences treatment increased risk death black patients disappearedour study shows racial disparity specialist consultation well subsequent treatment multimodality therapy metastatic colorectal cancer suggests inferior survival black patients may stem treatment disparity research underlying causes inequality improve access treatment survival metastatic colorectal cancer