Racial differences in the treatment of colorectal cancer: a comparison of surgical and radiation therapy between Whites and Blacks

Purpose To evaluate black to white differences in treatment for colorectal cancer. Methods Only whites or blacks diagnosed with colon or rectal cancer between 1988 and 1997 were identified from SEER database. Results A total of 106,377 (91.3% white, 50.5% male) patients formed the study population. The vast majority of these patients received standard cancer treatment. Although the number of subjects who did not receive such treatment was small, their proportion was higher among blacks than among whites. The odds of non-receipt of surgical treatment was higher among blacks than whites for stage I (OR = 2.08, 95% CI, 1.41, 3.03 among males; OR = 2.38, 95% CI, 1.69, 3.45 among females) and stage IV colon cancer (OR = 1.25, 95% CI, 1.01, 1.56 among males; OR = 1.41; 95% CI, 1.14, 1.72 among females). A similar pattern was also seen for most stages of rectal cancer. Conclusions Most black and white colorectal cancer patients received standard treatment. Although the number of subjects without standard treatment was small, their proportion was higher among blacks than among whites. Blacks were also more likely to refuse recommended treatment. Efforts in educating black patients about the benefits of treatment may help to eliminate the remaining racial disparity.