Patient-reported outcomes (PRO) before and after colorectal cancer (CRC) by race in a national survey.

Abstract

53 Background: There is significant disparities in the incidence, stage at diagnosis, and survival of CRC by race, however there is little evidence for disparities in patient reported health—an important quality of care metric. The SEER-CAHPS database (A linkage of Surveillance Epidemiology and End Results registry with Consumer Assessment of Healthcare Providers and Systems surveys) was used to explore the impact of CRC diagnosis on PRO. Methods: PRO was assessed by general health (GH) and mental health (MH). Responses of fair & poor to survey questions were classified as “modest”; and responses of excellent, very good, & good as “decent”. The responses were compared for surveys within 4 year window before or after CRC diagnosis. Logistic regression was used to identify variables associated with decline from decent to modest in the GH and MH. Results: The distribution of available surveys and outcome categories are presented in Table. CRC diagnosis was associated with a decline in MH (OR 1.42 95% CI 1.09 – 1.86 p-value < 0.05) and GH (OR 1.40 95% CI 1.17 – 1.67 p-value < 0.01). There was no association between race and decline in GH. However, compared to Whites, Blacks experienced lower odds of decline in MH (OR 0.396, 95% CI 0.185 - 0.848 p-value < 0.05). Hispanics had a trend for more pronounced decline in MH (OR 1.772, p value= 0.098). Tumor stage at diagnosis was a predictor of poorer GH (OR 1.75 95% CI 1.40 - 2.19 p-value < 0.01) and MH (OR 1.37 95% CI 1.00 - 1.87 p value = 0.048). Survey characteristics. Conclusions: Diagnosis of CRC is associated with decline in GH and MH across all racial groups, with worse MH and GH in patients with later stages of disease. Minorities experience gereater declines in MH. [Table: see text]