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Black Colon Cancer Patients And Adjuvant Treatment

Despite the improvement in overall survival among black patients with colon cancer, their survival still lags behind whites in the U.S. The reasons for this disparity are not well understood. Yothers et al. (p. 1498 ) obtained patient data from 12 North American randomized controlled trials (ACCENT collaboration) conducted between 1977 and 2002, and analyzed survival and related endpoints in black and white patients who received the same adjuvant treatment for resected stage II and III colon cancer. Results showed that overall survival (time to death) and recurrence-free survival (time to recurrence or death) were worse in black patients than whites, but there was no difference in recurrence-free interval (time to recurrence) between the two groups. The authors conclude that the survival difference was due to factors unrelated to adjuvant treatment.

In an accompanying editorial, Polite et al. (p. 1486 ) note that colorectal cancers are heterogeneous by nature, and not knowing the heterogeneity limits the interpretation of an otherwise excellent study. They mention that future analyses of outcomes by race need to integrate data on tumor biology, genetic and molecular alterations, comorbidity and sociodemographic information.