Health disparity in complicated colorectal cancer

The purpose of this study was to assess for disparity within a cohort of patients presenting with complicated colorectal cancer. A retrospective study of 522 patients who underwent surgery for colorectal cancer at a tertiary care institution was performed. Complicated cancer was defined by perforating or obstructing colonic lesions. Statistical analysis was conducted by χ² test and analysis of variance. Of the 522 patients, 72 patients (14%) presented with complicated colorectal cancer. Blacks in low-income brackets (36 vs 0%, P<0.001) and those with public insurance (55 vs 16%, P<0.05) had increased presentation with complicated colorectal cancers as compared with whites. Black (91%) and Hispanic women (86%), when compared with white women (37%) had increased incidence of complicated colorectal cancer (P<0.05). Patients in low-income brackets, regardless of race, had increased cancer recurrence rates (57 vs 8%, P < 0.001) compared with patients in average or high-income brackets. Mortality rate was 57 per cent in Hispanic, 29 per cent in white, and 27 per cent in black patients (P = nonsignificant). Specific targeting of colorectal cancer screening, education, and follow-up programs is imperative for minority women and patients of low socioeconomic status.