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U.S. CRC Mortality Racial Disparity Up in Last 20 Years

Black-white disparity seen at every disease stage; mainly driven by trends in late-stage disease

TUESDAY, Dec. 20 (HealthDay News) -- From 1985 to 2008, black-white disparities in U.S. colorectal cancer (CRC) mortality rates have increased for each disease stage, with trends in late-stage disease accounting for most of the overall disparity, according to a study published online Dec. 19 in the Journal of Clinical Oncology.

Anthony S. Robbins, M.D., Ph.D., from the American Cancer Society in Atlanta, and colleagues investigated whether racial disparities in CRC mortality rates (from 1985 to 2008) varied by stage at diagnosis. Data were collected from the Incidence-Based Mortality database from nine original Surveillance, Epidemiology, and End Results program regions. Changes in stage-specific mortality rates by race were the main outcomes measured.

The investigators found that, for all stages, CRC mortality rates decreased for both blacks and whites from 1985-1987 to 2006-2008; however, the declines for every stage were smaller in blacks, especially for distant-stage disease. Mortality rates for localized stage decreased 30.3 and 13.2 percent for whites and blacks, respectively. The corresponding decreases were 48.5 and 34.0 percent, respectively, for regional stage and 32.6 and 4.6 percent, respectively, for distant stage. The black-white rate ratios increased from 1.17 to 1.41 for localized disease, from 1.03 to 1.30 for regional disease, and from 1.21 to 1.72 for distant-stage disease. In absolute terms, approximately 60 percent of the black-white mortality disparity was a result of differences in distant-stage disease.

"The black-white disparities in CRC mortality increased for each stage of the disease," the authors write.

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