AI Article Synopsis
- Previous studies highlight healthcare disparities among the Texas-Mexico border population, prompting an analysis of colon cancer treatment and outcomes in this group compared to those outside the border.
- Over 43,000 patients were studied, revealing that those in the Texas-Mexico Border (TMB) area were predominantly Hispanic, had lower private insurance coverage, and received more suboptimal treatment compared to the Non-Texas-Mexico Border (NTMB) cohort.
- Although TMB patients had worse overall survival rates, the study concluded that living in the TMB area wasn't a direct risk factor; instead, issues like limited treatment quality and access to accredited hospitals contributed to the survival disparity.
Article Abstract
Background: Previous studies have reported healthcare disparities in the Texas-Mexico border population. Our aim was to evaluate treatment utilization and oncologic outcomes of colon cancer patients in this vulnerable population.
Methods: Patients with localized and regional colon cancer (CC) were identified in the Texas Cancer Registry (1995-2016). Clinicopathological data, hospital factors, receipt of optimal treatment, and overall survival (OS) were compared between Texas-Mexico Border (TMB) and the Non-Texas-Mexico Border (NTMB) cohorts. Multivariable analysis was performed to identify risk factors associated with decreased survival.
Results: We identified 43,557 patients with localized/regional CC (9% TMB and 91% NTMB). TMB patients were more likely to be Hispanic (73% versus 13%), less likely to have private insurance (13% versus 21%), were more often treated at safety net hospitals (82% versus 22%) and less likely at ACS-CoC accredited hospitals (32% versus 57%). TMB patients were more likely to receive suboptimal treatment (21% versus 16%) and had a lower median OS for localized (8.58 versus 9.58 y) and regional colon cancer (5.75 versus 6.18 y, all P < 0.001). In multivariable analysis, TMB status was not associated with worse OS. Factors associated with worse survival included receipt of suboptimal treatment, Medicare/insured status, and treatment in safety net and non-accredited ACS-CoC hospitals (all P < 0.001) CONCLUSIONS: While TMB CC patients had worse OS, TMB status itself was not found to be a risk factor for decreased survival. This survival disparity is likely associated with higher rate of suboptimal treatment, Medicare/Uninsured status, and decreased access to ACS-CoC accredited hospitals.
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| http://dx.doi.org/10.1016/j.jss.2021.05.040 | DOI Listing |
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