TY - JOUR
T1 - Colon Cancer Lymph Node Evaluation Among Military Health System Beneficiaries
T2 - An Analysis by Race/Ethnicity
AU - Gill, Abegail A.
AU - Zahm, Shelia H.
AU - Shriver, Craig D.
AU - Stojadinovic, Alexander
AU - McGlynn, Katherine A.
AU - Zhu, Kangmin
N1 - Funding Information:
The authors thank the following individuals and institutes for their contributions to or support for the original data linkage project: Mr. Guy J. Garnett, Mr. David E. Radune, and Dr. Aliza Fink of ICF Macro; Ms. Wendy Funk, Ms. Julie Anne Mutersbaugh, Ms. Linda Cottrell, and Ms. Laura Hopkins of Kennel and Associates, Inc.; Ms. Kim Frazier, Dr. Elder Granger, and Dr. Thomas V. Williams of TMA; Ms. Annette Anderson, Dr. Patrice Robinson, and Dr. Chris Owner of the Armed Forces Institute of Pathology; Dr. Joseph F. Fraumeni Jr, Dr. Robert N. Hoover, Dr. Susan S. Devesa, and Ms. Gloria Gridley of the National Cancer Institute; Dr. John Potter, Mr. Raul Parra, Ms. Anna Smith, Ms. Fiona Renalds, Mr. William Mahr, Mrs. Hongyu Wu, Dr. Larry Maxwell, Mr. Miguel Buddle, and Ms. Virginia Van Horn of the United States Military Cancer Institute. We would also like to thank Dr. Lindsey Enewold for her comments on this manuscript. This project was supported by the John P. Murtha Cancer Center, Walter Reed National Military Medical Center via the Uniformed Services University of the Health Sciences under the auspices of the Henry M. Jackson Foundation for the Advancement of Military Medicine and by the intramural research program of the National Cancer Institute. The original data linkage was supported by the United States Military Cancer Institute and Division of Cancer Epidemiology and Genetics, National Cancer Institute.
Publisher Copyright:
© 2014, Society of Surgical Oncology.
PY - 2015
Y1 - 2015
N2 - Results: No overall racial/ethnic differences in the number of lymph nodes examined was identified. Further stratified analyses yielded similar results, except potential racial/ethnic differences were found among persons with poorly differentiated tumors, where non-Hispanic Blacks tended to be less likely to have ≥12 lymph nodes dissected (odds ratio 0.34; 95 % confidence interval 0.14–0.80; p = 0.01) compared with non-Hispanic Whites.Conclusion: Racial/ethnic disparities in the number of lymph nodes evaluated among patients with colon cancer were not apparent in an equal-access healthcare system. However, among poorly differentiated tumors there might be racial/ethnic differences in nodal yield, suggesting the possible effects of factors other than access to healthcare.Background: The number of lymph nodes examined during colon cancer surgery falls below nationally recommended guidelines in the general population, with Blacks and Hispanics less likely to have adequate nodal evaluation in comparison to Whites. The Department of Defense’s (DoD) Military Health System (MHS) provides equal access to medical care for its beneficiaries, regardless of racial/ethnic background. This study aimed to investigate whether racial/ethnic treatment differences exist in the MHS, an equal-access medical care system.Methods: Linked data from the DoD cancer registry and administrative claims databases were used and included 2,155 colon cancer cases. Multivariate logistic regression assessed the association between race/ethnicity and the number of lymph nodes examined (<12 and ≥12) overall and for stratified analyses.
AB - Results: No overall racial/ethnic differences in the number of lymph nodes examined was identified. Further stratified analyses yielded similar results, except potential racial/ethnic differences were found among persons with poorly differentiated tumors, where non-Hispanic Blacks tended to be less likely to have ≥12 lymph nodes dissected (odds ratio 0.34; 95 % confidence interval 0.14–0.80; p = 0.01) compared with non-Hispanic Whites.Conclusion: Racial/ethnic disparities in the number of lymph nodes evaluated among patients with colon cancer were not apparent in an equal-access healthcare system. However, among poorly differentiated tumors there might be racial/ethnic differences in nodal yield, suggesting the possible effects of factors other than access to healthcare.Background: The number of lymph nodes examined during colon cancer surgery falls below nationally recommended guidelines in the general population, with Blacks and Hispanics less likely to have adequate nodal evaluation in comparison to Whites. The Department of Defense’s (DoD) Military Health System (MHS) provides equal access to medical care for its beneficiaries, regardless of racial/ethnic background. This study aimed to investigate whether racial/ethnic treatment differences exist in the MHS, an equal-access medical care system.Methods: Linked data from the DoD cancer registry and administrative claims databases were used and included 2,155 colon cancer cases. Multivariate logistic regression assessed the association between race/ethnicity and the number of lymph nodes examined (<12 and ≥12) overall and for stratified analyses.
UR - http://www.scopus.com/inward/record.url?scp=84939875128&partnerID=8YFLogxK
U2 - 10.1245/s10434-014-3939-4
DO - 10.1245/s10434-014-3939-4
M3 - Article
C2 - 25059789
AN - SCOPUS:84939875128
SN - 1068-9265
VL - 22
SP - 195
EP - 202
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 1
ER -