Racial differences in colorectal cancer mortality: The importance of stageand socioeconomic status

This investigation studies racial and socioeconomic differences in mortalit y from colorectal cancer, and how they vary by stage and age at diagnosis. Cox proportional hazards models were used to estimate the hazard ratio of d ying from colorectal cancer, controlling for tumor characteristics and soci odemographic factors. Black adults had a greater risk of death from colorec tal cancer, especially in early stages. The gender gap in mortality is wide r among blacks than whites. Differences in tumor characteristics and socioe conomic factors each accounted for approximately one third of the excess ri sk of death among blacks. Effects of socioeconomic factorsand race varied s ignificantly by age. Higher stage-specific mortality rates and more advance d stage at diagnosis both contribute to the higher case-fatality rates from colorectal cancer among black adults, only some of which is due to socioec onomic differences. Socioeconomic and racial factors have their most signif icant effects in different age groups. (C) 2001 Elsevier Science Inc. Ah ri ghts reserved.