Race Only Skin Deep in Colorectal Cancer Survival

Author:  Metcalfe David

Date:  May 2007

It has been said that color is only skin deep. Now, Dr. Xianglin Du and his colleagues at the University of Texas have shown that this adage holds true despite differences in survival between African-Americans and Caucasians suffering from colorectal cancer. According to their latest meta-analysis, published online this month by the journal Cancer, these differences are almost entirely due to social factors. As a result, the authors concluded that "efforts to eliminate racial disparities in health care and to minimize disparities in socioeconomic status have the potential to reduce racial inequalities in colon cancer survival".

In the last decade, a full half of African-Americans diagnosed with colorectal cancer have died within five years, compared with only a third of Caucasians. Until now, it remained unclear whether this was due to genetic or social reasons. One such social explanation is low socioeconomic status, which has long been associated with poor health outcomes. For example, previous research has shown that patients with low socioeconomic status experience barriers to healthcare, sub-optimal care and greater exposure to occupational and environmental hazards.

Now, Du and his colleagues have shown that social factors are more important than genetics in explaining the racial disparity in colorectal survival. To reach this conclusion, the researchers took data from ten different studies and compared individual sufferers against others from the same socioeconomic group. They found that, once socioeconomic status was held constant; there remained only minor differences in colorectal survival rates between African-Americans and Caucasians. This held true for individuals across all levels of the socioeconomic spectrum.

By David Metcalfe