Study shows the enduring impact of historical redlining on colon cancer care

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A nationwide study of 196 cities shows that housing discrimination from 90 years ago still casts a historical shadow of inequities in colon cancer care today, S.M. Qasim Hussaini, M.D.

Mar 28 2024University of Alabama at Birmingham , of the University of Alabama at Birmingham and colleagues at the American Cancer Society and Johns Hopkins School of Public Health report in the journal JCO Oncology Practice.

Overall, the researchers found that individuals diagnosed with colon cancer who resided in previously redlined HOLC D areas across the United States were today more likely to be diagnosed with advanced-stage disease, were less likely to receive guideline-concordant or timely treatment, and had worse survival.

In detail, individuals living in HOLC D areas were more likely to be diagnosed with late-stage colon cancer compared with those living in HOLC A areas. Of the 78,164 people who did not receive guideline-concordant care as defined by the National Comprehensive Cancer Network, the odds of receiving non-guideline concordant care increased for individuals residing in areas with increasing hazard grades assigned by HOLC B, HOLC C and HOLC D, as compared with individuals residing in HOLC A areas.

Related StoriesCompared with newly diagnosed colon cancer patients residing in HOLC A areas, those living HOLC C and D areas had 9 percent and 13 percent excess risk of death in statistical models that did not adjust for stage of the cancer at time of diagnosis. After stratification by stage -; either early, stages I and II, or advanced, stages III and IV -; the excess risk of death association persisted for the HOLC C and HOLC D areas for both the early and late stages at diagnosis.

The American Society of Clinical Oncology, or ASCO, defines health equity as a fair and just opportunity for everyone to be as healthy as possible. Colon cancer has about 150,000 new cases each year. It is the third most diagnosed cancer in the United States and the second leading cause of death from cancer, even though colon cancer is amenable to early detection and treatment. Widespread inequities in survival exist due to unequal access to care.

 

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