Health insurance counts for 54% of survival rate difference between black & white CRC patients: 3 insights

A study, published in Gastroenterology, examined how differences in insurance coverage, comorbidity, tumor characteristics and treatment affected colorectal cancer survival in African American and white patients.

Helmneh Sineshaw, MD, of the American Cancer Society, and colleagues used the National Cancer Database to examine African American and white CRC patients between 16 years and 64 years old. Researchers used five-year survival and Cox proportional hazard models to generate hazard ratios.

Here's what you should know:

1. The five-year survival rate difference between African American and white unmatched CRC patients was 9.2 percent. The survival rate for white patients was 66.5 percent, while the rate for African American patients was 57.3 percent.

2. Survival rate did not change after researchers matched patient groups to demographics. When matched to insurance coverage, survival rate decreased to 9.2 percent for white patients and 4.3 percent for African American patients. Survival decreased further for African American patients when matched by tumor characteristics to 2.4 percent.

3. In hazard models, insurance and tumor characteristics accounted for 54 percent and 27 percent of excess death risk for African American CRC patients, respectively.

Researchers concluded, "Insurance coverage differences accounted for approximately one-half of the disparity in survival rate between African American versus white patients … Tumor characteristics accounted for a quarter of the disparity. Affordable health insurance coverage for all populations could substantially reduce differences in survival times of African American versus white patients with CRC."

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