BACKGROUND: Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the United States. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival. METHODS: We used the MISCAN-Colon microsimulation model to estimate CRC incidence and mortality rates in blacks, aged 50 years and older, from 1975 to 2007 assuming they had: (i) the same trends in screening rates as whites instead of observed screening rates (incidence and mortality); (ii) the same trends in stage-specific relative CRC survival rates as whites instead of observed (mortality only); and (iii) a combination of both. The racial disparities in CRC incidence and mortality rates attributable to differences in screening and/or stage-specific relative CRC survival were then calculated by comparing rates from these scenarios to the observed black rates. RESULTS: Differences in screening accounted for 42% of disparity in CRC incidence and 19% of disparity in CRC mortality between blacks and whites. Thirty-six percent of the disparity in CRC mortality could be attributed to differences in stage-specific relative CRC survival. Together screening and survival explained a little more than 50% of the disparity in CRC mortality between blacks and whites. CONCLUSION: Differences in screening and relative CRC survival are responsible for a considerable proportion of the observed disparities in CRC incidence and mortality rates between blacks and whites. IMPACT: Enabling blacks to achieve equal access to care as whites could substantially reduce the racial disparities in CRC burden.
BACKGROUND: Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the United States. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival. METHODS: We used the MISCAN-Colon microsimulation model to estimate CRC incidence and mortality rates in blacks, aged 50 years and older, from 1975 to 2007 assuming they had: (i) the same trends in screening rates as whites instead of observed screening rates (incidence and mortality); (ii) the same trends in stage-specific relative CRC survival rates as whites instead of observed (mortality only); and (iii) a combination of both. The racial disparities in CRC incidence and mortality rates attributable to differences in screening and/or stage-specific relative CRC survival were then calculated by comparing rates from these scenarios to the observed black rates. RESULTS: Differences in screening accounted for 42% of disparity in CRC incidence and 19% of disparity in CRC mortality between blacks and whites. Thirty-six percent of the disparity in CRC mortality could be attributed to differences in stage-specific relative CRC survival. Together screening and survival explained a little more than 50% of the disparity in CRC mortality between blacks and whites. CONCLUSION: Differences in screening and relative CRC survival are responsible for a considerable proportion of the observed disparities in CRC incidence and mortality rates between blacks and whites. IMPACT: Enabling blacks to achieve equal access to care as whites could substantially reduce the racial disparities in CRC burden.
Authors: Donald Steinwachs; Jennifer Dacey Allen; William Eric Barlow; R Paul Duncan; Leonard E Egede; Lawrence S Friedman; Nancy L Keating; Paula Kim; Judith R Lave; Thomas A Laveist; Roberta B Ness; Robert J Optican; Beth A Virnig Journal: Ann Intern Med Date: 2010-04-13 Impact factor: 25.391
Authors: Carrie N Klabunde; Kathleen A Cronin; Nancy Breen; William R Waldron; Anita H Ambs; Marion R Nadel Journal: Cancer Epidemiol Biomarkers Prev Date: 2011-06-08 Impact factor: 4.254
Authors: J D Hardcastle; J O Chamberlain; M H Robinson; S M Moss; S S Amar; T W Balfour; P D James; C M Mangham Journal: Lancet Date: 1996-11-30 Impact factor: 79.321
Authors: V Paul Doria-Rose; Theodore R Levin; Joe V Selby; Polly A Newcomb; Kathryn E Richert-Boe; Noel S Weiss Journal: Gastroenterology Date: 2004-09 Impact factor: 22.682
Authors: James J Dignam; Yunrong Ye; Linda Colangelo; Roy Smith; Eleftherios P Mamounas; H Samuel Wieand; Norman Wolmark Journal: J Clin Oncol Date: 2003-02-01 Impact factor: 44.544
Authors: Samir Gupta; Daniel A Sussman; Chyke A Doubeni; Daniel S Anderson; Lukejohn Day; Amar R Deshpande; B Joseph Elmunzer; Adeyinka O Laiyemo; Jeanette Mendez; Ma Somsouk; James Allison; Taft Bhuket; Zhuo Geng; Beverly B Green; Steven H Itzkowitz; Maria Elena Martinez Journal: J Natl Cancer Inst Date: 2014-03-28 Impact factor: 13.506
Authors: Jennifer L Beebe-Dimmer; Terrance L Albrecht; Tara E Baird; Julie J Ruterbusch; Theresa Hastert; Felicity W K Harper; Michael S Simon; Judith Abrams; Kendra L Schwartz; Ann G Schwartz Journal: Cancer Epidemiol Biomarkers Prev Date: 2018-11-27 Impact factor: 4.254