Racial disparities in XXXX treatment: a population-based analysis.

@entity5 @entity1 @entity1442 @entity14
HYPOTHESIS: We hypothesized that there are significant racial disparities in delivery of care to @entity5 @entity1 . We examined differential surgical and radiation treatment for these @entity1 and determined whether blacks were less likely than whites to undergo sphincter-sparing procedures, which are associated with a higher quality of life than sphincter-ablating procedures. DESIGN: Cross-sectional cohort study. @entity1 AND SETTING: The Surveillance Epidemiology and End Results database provided population-based data for @entity5 @entity1 who were diagnosed between 1988 and 1999, were older than 35 years, and had no prior @entity14 . MAIN OUTCOME MEASURES: Using logistic regression, we compared receipt and type of surgical therapy and radiation therapy, controlling for age, sex, year, geography, stage, and anatomic location. RESULTS: Among 52 864 @entity1 , 3851 were black and 44 010 were white. Blacks were younger than whites and had more @entity1442 (P<.001). Among @entity1 who underwent operation, rates of sphincter-ablating procedure were 37% for whites and 43% for blacks (adjusted odds ratio [AOR], 1.42; 95% confidence interval [CI], 1.23-1.65). Moreover, 53% of whites and 56% of blacks received no radiation therapy for @entity5 (AOR, 1.30; 95% CI, 1.15-1.47). CONCLUSIONS: Blacks with @entity5 were diagnosed at a younger age and more @entity1442 stage than whites, implying a need for more aggressive screening. After adjusting for stage and other covariates, surgical and radiation treatment also differed along racial lines. Our data suggest that treatment disparities may contribute to differences in outcome among racial/ethnic groups with @entity5 , and they highlight the need for improving access to state-of-the-art surgical care for minority @entity1 with @entity5 .
