Colon cancer survival in California from 2004 to 2011 by stage at diagnosis, sex, race/ethnicity, and socioeconomic status

Abstract

BackgroundDisparities in cancer survival exist between groups. This study aims to examine these disparities in stage-, sex-, race/ethnicity-, and socioeconomic-specific colon cancer net survival in California for adults diagnosed between 2004 and 2011. MethodsWe estimated age-standardized net survival using the Pohar Perme estimator for colon cancer by stage at diagnosis (localized, regional, and distant), sex, race/ethnicity (Non-Hispanic White, Non-Hispanic Black, and Hispanic), and socioeconomic status (SES). Data from the Surveillance, Epidemiology, and End Results database on adults diagnosed with malignant colon cancer during 2004–2011 in California were included (n = 78,285). County-level SES was approximated using quintile groupings based on the Federal Poverty Level. ResultsFive-year survival for all included adults was 66.0 % (95 % CI: 65.6 %–66.4 %). The difference between Non-Hispanic White (White) adults and Non-Hispanic Black (Black) adults was 9.3 %, and between White adults and Hispanic adults was 3.4 %. A higher proportion of Black (24.5 %) and Hispanic (21.4 %) adults were diagnosed with distant disease compared to White adults (19.4 %). Differences in sex-specific survival were minimal, with only differences between Hispanic men (62.0 % [60.5 %–63.4 %]) and women (65.9 % [64.4 %–67.3 %]). SES differences were largest between the lowest quintile 63.0 % (62.3 %–65.2 %) and the highest quintile 67.8 % (66.8 %–68.8 %). SES-, stage-, and race/ethnicity-stratified analysis demonstrated improving trends for White adults with localized and regional disease, and Hispanic adults with regional disease. ConclusionColon cancer survival in California is lower for Black and Hispanic adults than for White adults in all three categories: stage, sex, and SES, suggesting the need for improved health policy for Hispanic and Black adults.