Racial differences in colorectal cancer mortality. The importance of stage and socioeconomic status

J Clin Epidemiol. 2001 Apr;54(4):359-66. doi: 10.1016/s0895-4356(00)00316-4.


This investigation studies racial and socioeconomic differences in mortality 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 dying from colorectal cancer, controlling for tumor characteristics and sociodemographic factors. Black adults had a greater risk of death from colorectal cancer, especially in early stages. The gender gap in mortality is wider among blacks than whites. Differences in tumor characteristics and socioeconomic factors each accounted for approximately one third of the excess risk of death among blacks. Effects of socioeconomic factors and race varied significantly by age. Higher stage-specific mortality rates and more advanced stage at diagnosis both contribute to the higher case-fatality rates from colorectal cancer among black adults, only some of which is due to socioeconomic differences. Socioeconomic and racial factors have their most significant effects in different age groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • African Americans / statistics & numerical data*
  • African Continental Ancestry Group / genetics
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / ethnology*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / pathology
  • European Continental Ancestry Group / genetics
  • European Continental Ancestry Group / statistics & numerical data*
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging*
  • Pennsylvania / epidemiology
  • Population Surveillance
  • Poverty / statistics & numerical data*
  • Proportional Hazards Models
  • Registries
  • Risk Factors
  • Sex Distribution
  • Survival Analysis
  • Time Factors