Highlights
- •Disparities are pronounced in patients with colorectal cancer.
- •Rates of advanced colorectal cancer have increased between 2004 and 2015.
- •Access to colorectal cancer screening should be prioritized.
Abstract
Background
We aimed to identify differences in disparities among patients with a cancer in which
screening is widely recommended (colorectal cancer [CRC]) and one in which it is not
(esophageal cancer).
Methods
A retrospective analysis was performed using 2004–2015 data from the National Cancer
Database. Multivariable generalized logistic regression was used to identify potential
differences in the effect of disparities in stage at diagnosis.
Results
A total of 96,524 esophageal cancer patients and 361,187 CRC patients were included.
Black patients, longer travel distances, and lower educational attainment were only
associated with increased odds of stage IV CRC. While both Medicaid and uninsured
patients were more likely to be diagnosed with stage IV esophageal and CRC, the effect
was larger among CRC patients. From 2004 to 2015, the rates of stage IV esophageal
cancer decreased from 42.0% to 38.2%, while the rates of stage IV CRC increased from
36.9% to 40.8% (p < 0.0001).
Conclusions
Disparities are more pronounced in CRC, compared to esophageal cancer. Equity in access
to screening and cancer care should be prioritized.
Keywords
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Article info
Publication history
Published online: December 23, 2019
Accepted:
December 19,
2019
Received in revised form:
December 16,
2019
Received:
May 27,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
