Race, Income, and Survival in Stage III Colon Cancer: CALGB 89803 (Alliance).
| Autor: | Lee S; Yale School of Medicine, New Haven, CT, USA., Zhang S; Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA., Ma C; Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA., Ou FS; Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA., Wolfe EG; Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA., Ogino S; Department of Oncologic Pathology, Dana-Farber/Partners CancerCare and Harvard Medical School, Boston, MA, USA.; Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Broad Institute of MIT and Harvard, Cambridge, MA, USA., Niedzwiecki D; Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA., Saltz LB; Memorial Sloan Kettering Cancer Center, New York, NY, USA., Mayer RJ; Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA., Mowat RB; Toledo Community Hospital Oncology Program, Toledo, OH, USA., Whittom R; Hôpital du Sacré-Coeur de Montréal, Montreal, Canada., Hantel A; Loyola University Stritch School of Medicine, Naperville, IL, USA., Benson A; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA., Atienza D; Virginia Oncology Associates, Norfolk, VA, USA., Messino M; Southeast Clinical Oncology Research Consortium, Mission Hospitals, Asheville, NC, USA., Kindler H; University of Chicago Comprehensive Cancer Center, Chicago, IL, USA., Venook A; University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA, USA., Gross CP; Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA., Irwin ML; Yale School of Public Health, New Haven, CT, USA., Meyerhardt JA; Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA., Fuchs CS; Yale School of Medicine, New Haven, CT, USA.; Yale Cancer Center, Smilow Cancer Hospital and Yale School of Medicine, New Haven, CT, USA.; Genentech, South San Francisco, CA, USA. |
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| Jazyk: | angličtina |
| Zdroj: | JNCI cancer spectrum [JNCI Cancer Spectr] 2021 Apr 12; Vol. 5 (3). Date of Electronic Publication: 2021 Apr 12 (Print Publication: 2021). |
| DOI: | 10.1093/jncics/pkab034 |
| Abstrakt: | 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 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. (© The Author(s) 2021. Published by Oxford University Press.) |
| Databáze: | MEDLINE |
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