Date:  April 23, 2007
Social Factors Not Genetics Drive Racial Disparities In Colorectal  
Cancer Survival, Study Says

Science Daily  Correcting social, economic and healthcare  
inequalities may have the most significant impact in reducing  
survival differences in colorectal cancer (CRC) between African  
Americans and Caucasians, according to a new study. Published in the  
June 1, 2007 issue of CANCER, a peer-reviewed journal of the American  
Cancer Society, a meta-analysis of data from published studies  
demonstrated that when socioeconomic factors and treatment  
utilization were controlled for or equalized, racial disparities were  
reduced substantially.

Lower socioeconomic status (SES) is well known to be associated with  
poorer health outcomes, including higher death rates. It is linked to  
impediments to healthcare access and receiving suboptimal care;  
higher risk of exposure to occupational and environmental hazards;  
and riskier behavior and less healthy lifestyles.

Survival differences in CRC between African Americans and whites have  
been well documented in the epidemiology literature. At the beginning  
of the 21st century, African Americans were dying from CRC at  
significant higher rates than white Americans. At five years after  
diagnosis, almost half of African Americans would be dead from CRC  
compared to just one third (35 percent) of white Americans. Research  
indicates that factors such as lower utilization of screening tests,  
lower rates of surgery and adjuvant chemotherapy, more aggressive  
tumors, and poor post-treatment surveillance contribute to lower  
survival rates. However, the fundamental causes of these  
associations, including the importance of biologic versus  
socioeconomic factors, remain poorly characterized.

For their new study, Dr. Xianglin Du, Tamra Meyer, and Dr. Luisa  
Franzini of the University Of Texas School Of Public Health at  
Houston reviewed the literature and aggregated the data from ten  
studies that investigated the association between CRC survival and  
race/ethnicity after controlling for SES and treatment. The meta- 
analysis approach aims to systematically review the existing  
literature, to allow a more objective appraisal of the evidence, to  
examine the heterogeneity between the studies, and if appropriate, to  
enhance the precision of the effect estimates.

The authors found that the overall risk of CRC-related death was only  
slightly elevated after adjusting for SES and treatment. African  
Americans had only marginally higher CRC mortality (hazard ratio:  
1.13, 95 percent confidence interval: 1.01-1.28) and all-cause  
mortality (hazard ratio: 1.14, 95 percent confidence interval:  

"These findings," conclude the authors, "demonstrated that there is  
no strong evidence of racial disparities in survival between African- 
Americans and Caucasians with colon cancer after accounting for  
racial differences in socioeconomic status." Therefore, conclude the  
authors, "efforts to eliminate racial disparities in health care and  
to minimize disparities in socioeconomic status have the potential to  
reduce racial inequalities in colon cancer survival."

Article: "Meta-analysis of Racial Disparities in Survival in  
Association With Socioeconomic Status Among Men and Women with Colon  
Cancer," Xianglin L. Du, Tamra E. Meyer, Luisa Franzini, CANCER:  
Published Online: April 23, 2007

(DOI: 10.1002/cncr.22664); Print Issue Date: June 1, 2007.

Note: This story has been adapted from a news release issued by John  
Wiley & Sons, Inc..

Copyright  1995-2007 ScienceDaily LLC

s. e. anderson (author of "The Black Holocaust for Beginners" -  
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