Differences in Insurance Coverage Associated With Nearly Half of Black-White Survival Disparity in Colorectal Cancer

Key Points

  • Researchers found the absolute 5-year survival difference between black and white colorectal cancer patients in the entire cohort was 9.2% (57.3% vs 66.5%).
  • That difference was cut almost in half—to 4.9%—after matching for insurance status.
  • Tumor characteristics also played a large role; the survival difference dropped to 2.3% after tumor characteristics matching.

Health insurance coverage differences account for nearly one-half of the black-white survival disparity in colorectal cancer patients, according to a new study published by Sineshaw et al in Gastroenterology. The findings reinforce the importance of equitable health insurance coverage to mitigate the black-white survival disparity in colorectal cancer.

Overall colorectal cancer incidence and mortality rates are decreasing in the United States as a result of earlier detection and improved treatments. Nonetheless, colorectal cancer incidence and mortality rates continue to be higher in blacks than in whites.

Study Findings

For the new study, investigators led by Helmneh Sineshaw, MD, MPH, at the American Cancer Society with collaborators from Dana-Farber Cancer Institute, focused on the impact of access to care on black-white survival disparity. They looked at 199,098 colorectal cancer patients ages 18 to 64 in the National Cancer Database.

Researchers found the absolute 5-year survival difference between black and white colorectal cancer patients in the entire cohort was 9.2% (57.3% vs 66.5%). That difference was cut almost in half—to 4.9%—after matching for insurance status. Tumor characteristics also played a large role; the survival difference dropped to 2.3% after tumor characteristics matching.

“These findings reinforce the importance of equitable health insurance coverage to mitigate the survival disparity between black vs white colorectal cancer patients in this age range and underscore the need for further studies to elucidate reasons for racial differences in tumor characteristics,” wrote the authors.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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