Download Comorbidity and Body Mass Index (BMI) as Predictors of Survival for

Comorbidity and Body Mass Index
(BMI) as Predictors of Survival for
African Americans and Caucasians
Following Surgery for Adenocarcinoma
of the Colon
Robert B. Hines, MPH
UAB Department of Epidemiology
School of Public Health
October 13, 2008
Colon Cancer
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Ranks third in terms of incidence and
mortality (CRC) for men and women.
The mortality picture and survival rate
associated with CRC has been improving
over the past 2-3 decades.
Despite these improvements, there continues
to be a survival disparity between nonHispanic African Americans and nonHispanic Caucasians.
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5-Year Survival for African
Americans and Caucasians
1975-77
1984-86
1996-2002
African Americans
46%
50%
54%
Caucasians
52%
60%
66%
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Reasons for the Survival Disparity
between African Americans and
Caucasians
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Numerous studies have proposed several reasons to
account for the racial differences in survival
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Stage
Decreased access to healthcare
1. Decreased screening
2. Lack of appropriate treatment
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Treatment
Differences in tumor-related characteristics
Comorbidity
Increased exposure to risk-factors among AAs (e.g. obesity)
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Comorbidity
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Comorbidity is defined as the presence of
other diseases in conjunction with an index
disease of primary interest.
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The study of comorbidity is becoming
increasingly recognized as an important
component of a cancer diagnosis.
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Increasing research interest
COC mandate
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Why Study Comorbidity?
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Cancer, specifically colon cancer, is a
diagnosis that is made among the older
segments of the population.
Comorbidity can influence the time of cancer
detection.
Comorbidity can influence receipt of
chemotherapy.
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Why Study Comorbidity in
Epidemiological Studies of
Cancer?
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Internal Validity
Effect Modification
Statistical Efficiency
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BMI and Colon Cancer
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