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    Contribution of screening and survival differences to racial disparities in colorectal cancer rates

    Access Status
    Open access via publisher
    Authors
    Lansdorp_Vogelaar, Iris
    Kuntz, K.
    Knudsen, A.
    Van Ballegooijen, M.
    Zauber, A.
    Jemal, A.
    Date
    2012
    Type
    Journal Article
    
    Metadata
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    Citation
    Lansdorp_Vogelaar, I. and Kuntz, K. and Knudsen, A. and Van Ballegooijen, M. and Zauber, A. and Jemal, A. 2012. Contribution of screening and survival differences to racial disparities in colorectal cancer rates. Cancer Epidemiology Biomarkers and Prevention. 21 (5): pp. 728-736.
    Source Title
    Cancer Epidemiology Biomarkers and Prevention
    DOI
    10.1158/1055-9965.EPI-12-0023
    ISSN
    1055-9965
    URI
    http://hdl.handle.net/20.500.11937/50079
    Collection
    • Curtin Research Publications
    Abstract

    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 inCRC 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.

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