Race, Income, and Survival in Stage III Colon Cancer: CALGB 89803 (Alliance)

被引：3

作者：

Lee, Seohyuk ^{[1
]}

Zhang, Sui ^{[2
]}

Ma, Chao ^{[2
]}

Ou, Fang-Shu ^{[3
]}

Wolfe, Eric G. ^{[3
]}

Ogino, Shuji ^{[4
,5
,6
,7
,8
]}

Niedzwiecki, Donna ^{[9
]}

Saltz, Leonard B. ^{[10
]}

Mayer, Robert J. ^{[2
]}

Mowat, Rex B. ^{[11
]}

Whittom, Renaud ^{[12
]}

Hantel, Alexander ^{[13
]}

Benson, Al ^{[14
]}

Atienza, Daniel ^{[15
]}

Messino, Michael ^{[16
]}

Kindler, Hedy ^{[17
]}

Venook, Alan ^{[18
]}

Gross, Cary P. ^{[19
]}

Irwin, Melinda L. ^{[20
]}

Meyerhardt, Jeffrey A. ^{[2
]}

Fuchs, Charles S. ^{[1
,21
,22
]}

机构：

[1] Yale Sch Med, New Haven, CT USA

[2] Dana Farber Partners CancerCare, Dept Med Oncol, Boston, MA USA

[3] Mayo Clin, Alliance Stat & Data Management Ctr, Rochester, MN USA

[4] Dana Farber Partners CancerCare, Dept Oncol Pathol, Boston, MA USA

[5] Harvard Med Sch, Boston, MA 02115 USA

[6] Brigham & Womens Hosp, Dept Pathol, Program MPE Mol Pathol Epidemiol, 75 Francis St, Boston, MA 02115 USA

[7] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

[8] Broad Inst MIT & Harvard, Cambridge, MA 02142 USA

[9] Duke Univ, Dept Biostat & Bioinformat, Durham, NC USA

[10] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[11] Toledo Community Hosp Oncol Program, Toledo, OH USA

[12] Hop Sacre Coeur Montreal, Montreal, PQ, Canada

[13] Loyola Univ, Stritch Sch Med, Naperville, IL USA

[14] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA

[15] Virginia Oncol Associates, Norfolk, VA USA

[16] Mission Hosp, Southeast Clin Oncol Res Consortium, Asheville, NC USA

[17] Univ Chicago, Comprehens Canc Ctr, Chicago, IL 60637 USA

[18] Univ Calif San Francisco, Comprehens Canc Ctr, San Francisco, CA 94143 USA

[19] Yale Sch Med, Dept Internal Med, New Haven, CT USA

[20] Yale Sch Publ Hlth, New Haven, CT USA

[21] Smilow Canc Hosp, Yale Canc Ctr, New Haven, CT USA

[22] Genentech Inc, San Francisco, CA 94080 USA

来源：

JNCI CANCER SPECTRUM | 2021年 / 5卷 / 03期

基金：

美国国家卫生研究院;

关键词：

COLORECTAL-CANCER; RACIAL DISPARITIES; SOCIOECONOMIC-STATUS; AFRICAN-AMERICANS; PHYSICAL-ACTIVITY; ADJUVANT THERAPY; BREAST-CANCER; MORTALITY; OUTCOMES; ASSOCIATION;

D O I：

10.1093/jncics/pkab034

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Disparities in colon cancer outcomes have been reported across race and socioeconomic status, which may reflect, in part, access to care. We sought to assess the influences of race and median household income (MHI) on outcomes among colon cancer patients with similar access to care. Methods We conducted a prospective, observational study of 1206 stage III colon cancer patients enrolled in the CALGB 89803 randomized adjuvant chemotherapy trial. Race was self-reported by 1116 White and 90 Black patients at study enrollment; MHI was determined by matching 973 patients' home zip codes with publicly available US Census 2000 data. Multivariate analyses were adjusted for baseline sociodemographic, clinical, dietary, and lifestyle factors. All statistical tests were 2-sided. Results Over a median follow-up of 7.7 years, the adjusted hazard ratios for Blacks (compared with Whites) were 0.94 (95% confidence interval [CI] = 0.66 to 1.35, P = .75) for disease-free survival, 0.91 (95% CI = 0.62 to 1.35, P = .65) for recurrence-free survival, and 1.07 (95% CI = 0.73 to 1.57, P = .73) for overall survival. Relative to patients in the highest MHI quartile, the adjusted hazard ratios for patients in the lowest quartile were 0.90 (95% CI = 0.67 to 1.19, P-trend = .18) for disease-free survival, 0.89 (95% CI = 0.66 to 1.22, P-trend = .14) for recurrence-free survival, and 0.87 (95% CI = 0.63 to 1.19, P-trend = .23) for overall survival. Conclusions In this study of patients with similar health-care access, no statistically significant differences in outcomes were found by race or MHI. The substantial gaps in outcomes previously observed by race and MHI may not be rooted in differences in tumor biology but rather in access to quality care.

引用

页数：11

共 62 条

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