In the US, colorectal cancer (CRC) is the third most prevalent cancer. It is also the third and fourth deadliest cancer for men and women, respectively. High-poverty areas (HPAs), where at least 20 percent of residents live under federal poverty, face disproportionately higher CRC mortality compared with low-poverty areas (LPAs). This is even more pronounced in persistent-poverty areas (PPAs) that have had high poverty for at least 30 years. Prior research indicates that the location where patients receive CRC treatment may significantly impact their outcomes. However, research on the impact of treatment settings on disparities experienced by individuals with cancer residing in HPAs is scarce.
In an article in the Annals of Surgical Oncology, Dr. Jialin Mao, assistant professor of population health sciences, and colleagues aimed to fill this research gap. Their study, funded by the Center for Social Capital (SoCa), determined whether certain hospitals predominantly provided surgical care for patients with CRC from HPAs and examined associated patient outcomes.
Results indicate that a group of poverty-area-serving (PAS) hospitals treated a significant proportion of patients with CRC residing in HPAs, but few from LPAs. Patients with CRC residing in HPAs who were treated at PAS hospitals had worse in-hospital outcomes, 30-day readmission rates, and long-term mortality compared with those residing in LPAs treated at non-PAS hospitals.
These observations demonstrate the presence of health care segregation by area-level poverty in CRC care. Poorer outcomes among individuals from HPAs treated at PAS hospitals may be linked to a variety of health care or social factors, such as lack of resources and lower-quality surgical care at these hospitals.
“We are grateful to the National Cancer Institute and SoCa for providing pilot funding for us to initiate investigations in this area,” said Dr. Mao. “By bringing attention to this vulnerable population, the disparities they experience, and potential contributing factors on the structural level, we hope to identify strategies to improve quality of care and address the health care needs of individuals from disadvantaged areas.”
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