Claire J Yang, Harry Kim, Michael Tam, Vikram Attaluri, Anna Leung
{"title":"在一个封闭的医疗服务系统中减轻转移性结直肠癌手术治疗和预后的种族和民族差异。","authors":"Claire J Yang, Harry Kim, Michael Tam, Vikram Attaluri, Anna Leung","doi":"10.7812/TPP/24.178","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Previous studies have demonstrated racial and ethnic disparities in the treatment and outcomes of patients with colorectal cancer. However, none of these studies has examined whether these disparities exist in a closed health care delivery system. The aim of this study was to identify racial and ethnic disparities in rates of diagnosis, treatment, and outcomes for patients with colorectal cancer with liver metastasis (CRLM) within the Kaiser Permanente Southern California system.</p><p><strong>Methods: </strong>The authors performed a retrospective review of 110 adult patients with CRLM who underwent surgery on both sites with curative intent at any Kaiser Permanente Southern California facility between 2010 and 2020. The authors stratified patients by race and ethnicity as Asian/Asian American, Black, Hispanic, or White individuals.</p><p><strong>Results: </strong>There was a statistically significant difference in race and ethnicity breakdown between all Kaiser Permanente members and the patients diagnosed with CRLM (<i>P</i> < .01), with a lower proportion of Hispanic patients diagnosed (<i>P</i> < .01). Between the surgical and nonsurgical cohorts, the statistically significant difference between race and ethnicity breakdown (<i>P</i> = .03) was due to Hispanic patients being more likely to undergo surgery (<i>P</i> = .01). Between racial and ethnic groups within the surgical cohort there was no significant difference in mean age at diagnosis (<i>P</i> = .63), time from diagnosis to surgical resection (<i>P</i> = .64), proportion of synchronous vs metachronous resections (<i>P</i> = .53), complication rate (<i>P</i> = .91), recurrence rate (<i>P</i> = .40), or 5- and 10-year survival (<i>P</i> = .5 and <i>P</i> = .9).</p><p><strong>Conclusion: </strong>Within a closed health care delivery system, racial and ethnic disparities in treatment and outcomes were not observed for surgical patients with CRLM. However, disparities in diagnosis for the Hispanic population persist and should be addressed.</p>","PeriodicalId":23037,"journal":{"name":"The Permanente journal","volume":" ","pages":"24-31"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485250/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mitigation of Racial and Ethnic Disparities in Surgical Treatment and Outcomes of Metastatic Colorectal Cancer in a Closed Health Care Delivery System.\",\"authors\":\"Claire J Yang, Harry Kim, Michael Tam, Vikram Attaluri, Anna Leung\",\"doi\":\"10.7812/TPP/24.178\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Previous studies have demonstrated racial and ethnic disparities in the treatment and outcomes of patients with colorectal cancer. However, none of these studies has examined whether these disparities exist in a closed health care delivery system. The aim of this study was to identify racial and ethnic disparities in rates of diagnosis, treatment, and outcomes for patients with colorectal cancer with liver metastasis (CRLM) within the Kaiser Permanente Southern California system.</p><p><strong>Methods: </strong>The authors performed a retrospective review of 110 adult patients with CRLM who underwent surgery on both sites with curative intent at any Kaiser Permanente Southern California facility between 2010 and 2020. The authors stratified patients by race and ethnicity as Asian/Asian American, Black, Hispanic, or White individuals.</p><p><strong>Results: </strong>There was a statistically significant difference in race and ethnicity breakdown between all Kaiser Permanente members and the patients diagnosed with CRLM (<i>P</i> < .01), with a lower proportion of Hispanic patients diagnosed (<i>P</i> < .01). Between the surgical and nonsurgical cohorts, the statistically significant difference between race and ethnicity breakdown (<i>P</i> = .03) was due to Hispanic patients being more likely to undergo surgery (<i>P</i> = .01). Between racial and ethnic groups within the surgical cohort there was no significant difference in mean age at diagnosis (<i>P</i> = .63), time from diagnosis to surgical resection (<i>P</i> = .64), proportion of synchronous vs metachronous resections (<i>P</i> = .53), complication rate (<i>P</i> = .91), recurrence rate (<i>P</i> = .40), or 5- and 10-year survival (<i>P</i> = .5 and <i>P</i> = .9).</p><p><strong>Conclusion: </strong>Within a closed health care delivery system, racial and ethnic disparities in treatment and outcomes were not observed for surgical patients with CRLM. However, disparities in diagnosis for the Hispanic population persist and should be addressed.</p>\",\"PeriodicalId\":23037,\"journal\":{\"name\":\"The Permanente journal\",\"volume\":\" \",\"pages\":\"24-31\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485250/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Permanente journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.7812/TPP/24.178\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"Social Sciences\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Permanente journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7812/TPP/24.178","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Social Sciences","Score":null,"Total":0}
Mitigation of Racial and Ethnic Disparities in Surgical Treatment and Outcomes of Metastatic Colorectal Cancer in a Closed Health Care Delivery System.
Background: Previous studies have demonstrated racial and ethnic disparities in the treatment and outcomes of patients with colorectal cancer. However, none of these studies has examined whether these disparities exist in a closed health care delivery system. The aim of this study was to identify racial and ethnic disparities in rates of diagnosis, treatment, and outcomes for patients with colorectal cancer with liver metastasis (CRLM) within the Kaiser Permanente Southern California system.
Methods: The authors performed a retrospective review of 110 adult patients with CRLM who underwent surgery on both sites with curative intent at any Kaiser Permanente Southern California facility between 2010 and 2020. The authors stratified patients by race and ethnicity as Asian/Asian American, Black, Hispanic, or White individuals.
Results: There was a statistically significant difference in race and ethnicity breakdown between all Kaiser Permanente members and the patients diagnosed with CRLM (P < .01), with a lower proportion of Hispanic patients diagnosed (P < .01). Between the surgical and nonsurgical cohorts, the statistically significant difference between race and ethnicity breakdown (P = .03) was due to Hispanic patients being more likely to undergo surgery (P = .01). Between racial and ethnic groups within the surgical cohort there was no significant difference in mean age at diagnosis (P = .63), time from diagnosis to surgical resection (P = .64), proportion of synchronous vs metachronous resections (P = .53), complication rate (P = .91), recurrence rate (P = .40), or 5- and 10-year survival (P = .5 and P = .9).
Conclusion: Within a closed health care delivery system, racial and ethnic disparities in treatment and outcomes were not observed for surgical patients with CRLM. However, disparities in diagnosis for the Hispanic population persist and should be addressed.
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