Race does not impact colorectal cancer treatment or outcomes with equal access

Background: Ethnicity is implicated as a factor for disparate outcomes in colorectal cancer. We sought to evaluate this relationship at a military medical center organized to deliver equitable health care. Methods: Retrospective analysis of colorectal cancer patients comparing demographics, grade, American Joint Committee on Cancer (AJCC) stage, and adjuvant therapy. Results: From January 1994 to January 2004, 398 patients were treated with colorectal cancer (74 [19%] nonwhites). Comparatively, nonwhites were younger and had fewer stage II tumors with a increased proportion of stage III tumors (P < .01). With a median follow-up period of 52 (0-151) months, there were no disparities in surgical resection, adjuvant therapy, or disease recurrence. Kaplan-Meier analysis revealed no disparity in disease-free and cancer-specific survival (P = .585 and P = .132); Cox regression revealed increased age and AJCC stage III as the only independent predictors of lower survival (P < .05). Conclusions: Ethnicity was associated with differences in age and AJCC stage at presentation. In an equitable health care system, these differences did not impact patients' treatment or survival.