Late Presentation of Colorectal Cancer in a Vulnerable Population

Overview

Journal Am J Gastroenterol

Specialty Gastroenterology

Date 2013 Apr 5

PMID 23552303

Citations 3

Authors

Chanda Ho

Rachel Kornfield

Eric Vittinghoff

John Inadomi

Hal Yee

Ma Somsouk

Affiliations

Soon will be listed here.

Abstract

Objectives: We examined colorectal cancer (CRC) stage at presentation and mortality in a vulnerable population compared with nationally representative data.

Methods: CRC cases were identified from San Francisco General Hospital (SFGH) and the Surveillance Epidemiology and End Results (SEER) database.

Results: Fifty-five percent of the SFGH cohort presented with advanced disease, compared with 44% of the SEER cohort. Increased risk of advanced stage at presentation at SFGH compared with SEER was most evident among blacks and Asians. There was weak evidence for worse survival at SFGH compared with SEER overall. This varied by race with poorer survival at SFGH among whites and possibly blacks but some evidence for better survival among Asians. Among CRC patients at SFGH, Asians and Hispanics had better survival than whites and blacks. At SFGH, 44% had a diagnosis of CRC within 1 year of establishing care there. Of those who had established care at SFGH for at least 1 year, only 22% had exposure to CRC screening tests.

Conclusions: These findings allow examination of CRC presentation by ethnicity in vulnerable populations and identify areas where access and utilization of CRC screening can be improved.

Citing Articles

Colorectal cancer and potential predictors of never screened for faecal occult blood test: a narrative review.

Sazali M, Syed Abdul Rahim S, Hayati F, Daud M, Avoi R, Omar A J Public Health Res. 2021; 11(1).

PMID: 34351098 PMC: 8859728. DOI: 10.4081/jphr.2021.2377.

A statewide program providing colorectal cancer screening to the uninsured of South Carolina.

Eberth J, Thibault A, Caldwell R, Josey M, Qiang B, Pena E Cancer. 2018; 124(9):1912-1920.

PMID: 29415338 PMC: 5910186. DOI: 10.1002/cncr.31250.

Inadequate Utilization of Diagnostic Colonoscopy Following Abnormal FIT Results in an Integrated Safety-Net System.

Issaka R, Singh M, Oshima S, Laleau V, Rachocki C, Chen E Am J Gastroenterol. 2017; 112(2):375-382.

PMID: 28154400 PMC: 6597438. DOI: 10.1038/ajg.2016.555.

References

Walsh J, Kaplan C, Nguyen B, Gildengorin G, McPhee S, Perez-Stable E . Barriers to colorectal cancer screening in Latino and Vietnamese Americans. Compared with non-Latino white Americans. J Gen Intern Med. 2004; 19(2):156-66. PMC: 1492137. DOI: 10.1111/j.1525-1497.2004.30263.x. View

Clegg L, Li F, Hankey B, Chu K, Edwards B . Cancer survival among US whites and minorities: a SEER (Surveillance, Epidemiology, and End Results) Program population-based study. Arch Intern Med. 2002; 162(17):1985-93. DOI: 10.1001/archinte.162.17.1985. View

Hasnain-Wynia R, Baker D, Nerenz D, Feinglass J, Beal A, Landrum M . Disparities in health care are driven by where minority patients seek care: examination of the hospital quality alliance measures. Arch Intern Med. 2007; 167(12):1233-9. DOI: 10.1001/archinte.167.12.1233. View

Soneji S, Iyer S, Armstrong K, Asch D . Racial disparities in stage-specific colorectal cancer mortality: 1960-2005. Am J Public Health. 2010; 100(10):1912-6. PMC: 2936993. DOI: 10.2105/AJPH.2009.184192. View

Woolf S, Braveman P . Where health disparities begin: the role of social and economic determinants--and why current policies may make matters worse. Health Aff (Millwood). 2011; 30(10):1852-9. DOI: 10.1377/hlthaff.2011.0685. View

McHugh M, Kang R, Hasnain-Wynia R . Understanding the safety net: inpatient quality of care varies based on how one defines safety-net hospitals. Med Care Res Rev. 2009; 66(5):590-605. DOI: 10.1177/1077558709334895. View

Eisert S, Mehler P, Gabow P . Can America's urban safety net systems be a solution to unequal treatment?. J Urban Health. 2008; 85(5):766-78. PMC: 2527432. DOI: 10.1007/s11524-008-9296-5. View

McAlearney A, Reeves K, Dickinson S, M Kelly K, Tatum C, Katz M . Racial differences in colorectal cancer screening practices and knowledge within a low-income population. Cancer. 2007; 112(2):391-8. PMC: 4465260. DOI: 10.1002/cncr.23156. View

Shankar S, Selvin E, Alberg A . Perceptions of cancer in an African-American community: a focus group report. Ethn Dis. 2002; 12(2):276-83. View

10.

Jemal A, Siegel R, Xu J, Ward E . Cancer statistics, 2010. CA Cancer J Clin. 2010; 60(5):277-300. DOI: 10.3322/caac.20073. View

11.

Cooper G, Koroukian S . Racial disparities in the use of and indications for colorectal procedures in Medicare beneficiaries. Cancer. 2004; 100(2):418-24. DOI: 10.1002/cncr.20014. View

12.

Govindarajan R, Shah R, Erkman L, Hutchins L . Racial differences in the outcome of patients with colorectal carcinoma. Cancer. 2003; 97(2):493-8. DOI: 10.1002/cncr.11067. View

13.

Gupta S, Tong L, Allison J, Carter E, Koch M, Rockey D . Screening for colorectal cancer in a safety-net health care system: access to care is critical and has implications for screening policy. Cancer Epidemiol Biomarkers Prev. 2009; 18(9):2373-9. PMC: 2767330. DOI: 10.1158/1055-9965.EPI-09-0344. View

14.

Inadomi J, Vijan S, Janz N, Fagerlin A, Thomas J, Lin Y . Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012; 172(7):575-82. PMC: 3360917. DOI: 10.1001/archinternmed.2012.332. View

15.

Werner R, Elizabeth Goldman L, Dudley R . Comparison of change in quality of care between safety-net and non-safety-net hospitals. JAMA. 2008; 299(18):2180-7. DOI: 10.1001/jama.299.18.2180. View

16.

Mandel J, Bond J, Church T, Snover D, Bradley G, SCHUMAN L . Reducing mortality from colorectal cancer by screening for fecal occult blood. Minnesota Colon Cancer Control Study. N Engl J Med. 1993; 328(19):1365-71. DOI: 10.1056/NEJM199305133281901. View

17.

Elizabeth Goldman L, Vittinghoff E, Dudley R . Quality of care in hospitals with a high percent of Medicaid patients. Med Care. 2007; 45(6):579-83. DOI: 10.1097/MLR.0b013e318041f723. View

18.

Dimou A, Syrigos K, Saif M . Disparities in colorectal cancer in African-Americans vs Whites: before and after diagnosis. World J Gastroenterol. 2009; 15(30):3734-43. PMC: 2726450. DOI: 10.3748/wjg.15.3734. View

19.

Selby J, Friedman G, Quesenberry Jr C, Weiss N . Effect of fecal occult blood testing on mortality from colorectal cancer. A case-control study. Ann Intern Med. 1993; 118(1):1-6. DOI: 10.7326/0003-4819-118-1-199301010-00001. View

20.

OMalley A, Beaton E, Yabroff K, Abramson R, Mandelblatt J . Patient and provider barriers to colorectal cancer screening in the primary care safety-net. Prev Med. 2004; 39(1):56-63. DOI: 10.1016/j.ypmed.2004.02.022. View