Abstract C17: Unequal Financial Burdens Highlight Racial Disparities of Colon Cancer Patients in New York

Abstract

Abstract Background: We have previously investigated racial disparities in colorectal cancer outcomes and discovered outcomes differences according to racial group. In our ongoing studies we sought to determine whether these disparities in survival resulted in unequal financial burdens between black and white patients. The purpose of this study was to identify whether financial disparities exist between the black and Caucasian colorectal cancer patients within New York State, with the ultimate goal of eliminating any differences. Research Design: The Statewide Planning and Research Cooperative System (SPARCS) database of New York State (NYS) was used to compare costs of colon cancer surgery hospitalizations of the black and Caucasian patient populations between 2009-2013. Student t-tests were performed for comparison of inpatient hospital discharge, ambulatory surgery, and emergency department admission within the SPARCS database. Facility costs were calculated using hospital discharge data and Institutional Cost Reports. Logistic regression analysis examined race as the dependent variable to identify the etiology of cost disparity. Results: Overall, 26,477 patients (white, n= 21,606; and black, n=4,871) underwent colon cancer treatment. Treatment costs in the black population were higher compared to the white population (mean, $64,747 vs $58,127; median, $44,951 vs $41, 285) (p<0.001). Emergent operations were more frequent in the black population (52% vs 37%)(p<0.001), as well as the median length of stay in the hospital (7 days vs 6 days) (p<0.001). After these data were normalized with respect to length of stay and percentage of emergent operations, the costs for blacks were lower than the costs for Caucasians. Conclusion: This study revealed that the black colon cancer population had higher costs than the Caucasian colon cancer population. We identified emergent operations and longer hospitalization as the primary etiologies for this disparity. Sufficient colon cancer screening for the black population might reduce the number of emergent operations and reduce length of hospitalization if the cancer is detected at an earlier stage. Note: This abstract was not presented at the conference. Citation Format: Brian C. Oveson, Purvi Parikh, Dana Telem, Jennifer Williams, Roberto Bergamaschi, Aaron Sasson, Mark Talamini, Joseph Kim. Unequal Financial Burdens Highlight Racial Disparities of Colon Cancer Patients in New York. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C17.