In a study published by Frankenfeld et al in Cancer Epidemiology, researchers found racial disparities in how the presence of cancer-related diagnostic and treatment technology is related to colorectal cancer patient outcomes in Georgia. The findings suggest that the hospital capacity and availability of advanced technologies may benefit white patients, but not black patients, in terms of time to treatment and overall survival.

Analysis Details

The study evaluated time to treatment and survival rates of patients in relation to cancer-related technologies of the diagnosing hospital using colorectal tumor-level data from the Georgia Cancer Registry merged with hospital-level data from the American Hospital Association from 2010 to 2015. There were 11,453 colon tumors and 4,591 rectosigmoid/rectal tumors included in the analyses.

Researchers sought to better understand how structural issues at the hospital level influence differences in cancer outcomes across racial groups.

Results

Based on the data from the Georgia Cancer Registry, black patients experienced longer time to treatment (including surgery) and lower likelihood of treatment. However, the median time to treatment was similar across white and black patient groups.

Factors such as hospital capacity or size indicators (eg, total surgical operations, licensed beds, and emergency room visits) were associated with earlier treatment in white patients, but not black patients. Higher counts of treatment-related technologies were also associated with better survival for white patients, but not black patients. Despite disparities in other factors, availability of virtual colonoscopy technologies emerged as a technology related to survival favorability in both black and white patients.

These results suggest that characteristics of diagnosing hospitals influence overall treatment and survival, but more work is needed to better characterize these influences and differences observed for white and black racial groups before specific recommendations to improve patient outcomes can be made. The study also provides an important foundation for future research in additional geographic locations.

Cara L. Frankenfeld, PhD

“Structural influences on disease progression need further study, and this work contributes a piece to that complex puzzle,” said first study author Cara L. Frankenfeld, PhD. “Understanding the long-term influences or consequences of where people get diagnosed with colorectal cancer and attempting to identify modifiable factors that benefit patients could be helpful to patients, as they think about colorectal cancer prevention and detection. Hospitals also benefit as they consider resource acquisition and utilization.”

Disclosure: For full disclosures of the study authors, visit sciencedirect.com.