Solomiya Syvyk1, Sanford E Roberts2, Caitlin B Finn3, Chris Wirtalla2, Rachel Kelz4. 1. Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia PA, USA. 2. Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia PA, USA; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia PA, USA; NewYork-Presbyterian Hospital/Weill Cornell Medicine, Department of Surgery, New York, NY, USA. 4. Center for Surgery and Health Economics, Department of Surgery, University of Pennsylvania, Philadelphia PA, USA; Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: Rachel.Kelz@uphs.upenn.edu.
Abstract
BACKGROUND: Disparate colorectal cancer outcomes persist in vulnerable populations. We aimed to examine the distribution of research across the colorectal cancer care continuum, and to determine disparities in the utilization of Surgery among Black patients. METHODS: A systematic review and meta-analysis of colorectal cancer disparities studies was performed. The meta-analysis assessed three utilization measures in Surgery. RESULTS: Of 1,199 publications, 60% focused on Prevention, Screening, or Diagnosis, 20% on Survivorship, 15% on Treatment, and 1% on End-of-Life Care. A total of 16 studies, including 1,110,674 patients, were applied to three meta-analyses regarding utilization of Surgery. Black patients were less likely to receive surgery, twice as likely to refuse surgery, and less likely to receive laparoscopic surgery, when compared to White patients. CONCLUSIONS: Since 2011, the majority of research focused on prevention, screening, or diagnosis. Given the observed treatment disparities among Black patients, future efforts to reduce colorectal cancer disparities should include interventions within Surgery.
BACKGROUND: Disparate colorectal cancer outcomes persist in vulnerable populations. We aimed to examine the distribution of research across the colorectal cancer care continuum, and to determine disparities in the utilization of Surgery among Black patients. METHODS: A systematic review and meta-analysis of colorectal cancer disparities studies was performed. The meta-analysis assessed three utilization measures in Surgery. RESULTS: Of 1,199 publications, 60% focused on Prevention, Screening, or Diagnosis, 20% on Survivorship, 15% on Treatment, and 1% on End-of-Life Care. A total of 16 studies, including 1,110,674 patients, were applied to three meta-analyses regarding utilization of Surgery. Black patients were less likely to receive surgery, twice as likely to refuse surgery, and less likely to receive laparoscopic surgery, when compared to White patients. CONCLUSIONS: Since 2011, the majority of research focused on prevention, screening, or diagnosis. Given the observed treatment disparities among Black patients, future efforts to reduce colorectal cancer disparities should include interventions within Surgery.