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Stage-specific life expectancy lower in blacks; unequal health care access, quality may have role

-- Jeff Muise

Friday, August 27, 2010 (Last Updated: 08/31/2010)

FRIDAY, Aug. 27 (HealthDay News) -- Stage-specific colorectal cancer (CRC) survival and life expectancy have been worse for blacks than whites over the past few decades, and the disparities appear to be due to differences in quality of and access to care, according to research published online Aug. 19 in the American Journal of Public Health.

Samir Soneji, Ph.D., of the University of Pennsylvania in Philadelphia, and colleagues used U.S. mortality data and intercensal estimates to calculate mortality rates by gender and race for the years 1960 to 2005. Surveillance, Epidemiology, and End Results data were also used to estimate CRC survival for disease stages by gender and race.

The researchers found that white men had a 39 percent reduction in CRC deaths over the period, while black men had a 28 percent increase; white women had a 54 percent reduction compared to a 14 percent reduction in black women. Blacks experienced consistently lower rates of stage-specific life expectancy and survival than whites over the study period; this was true for all age groups; both genders; and localized, regional, and distant disease stages. The authors concluded that the disparities in stage-specific life expectancy could be attributed to differences in quality of care and access to care.

"Because racial disparity is unlikely to be a product of differences in the accuracy of staging, tumor biology, or competing mortality, racial disparity seems most likely to be a product of differences in access to care or the quality of that care. The existence of racial differences in CRC management demands attention, and the increase of those disparities over the past several four decades should make this a priority," the authors write.

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Family Practice

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