Black patients more likely to get emergency colorectal cancer surgery

Emergency surgery was linked to less thorough pre-surgical assessments and worse outcomes after surgery.

5:00 AM

Author | Mary Clare Fischer

Graphic of a surgery table with Lab Note in the upper left corner.
Jacob Dwyer, Justine Ross, Michigan Medicine

In an analysis of data from hospitals across the state of Michigan, University of Michigan researchers found that Black, non-Hispanic patients were more likely to undergo emergency surgery for colorectal cancer than other races and ethnicities.

Undergoing emergency surgery was associated with a higher rate of complications, including death. Out of close to 5,000 patients who underwent any type of surgery for colorectal cancer, 23% had emergency surgery — but those patients made up 63% of the deaths.

Patients who underwent emergency surgery also received less complete evaluations and testing as part of their workup by surgeons and their medical teams.

“Overall, these results suggest that racial and ethnic differences persist in presentation and management of colorectal cancer and that these differences likely contribute to disparities in postoperative outcomes among these groups,” said Ryan Howard, M.D., M.S., a general surgery resident at University of Michigan Health and the first author of the study.

Howard and his research team used data from the Michigan Surgical Quality Collaborative, a statewide initiative funded by Blue Cross Blue Shield of Michigan that aims to improve the quality and cost of surgical care across the state.

Their goal was to identify opportunities to improve patient care earlier in the process of cancer diagnosis and treatment.

“We can spend all day working on, say, reducing complications right after surgery,” Howard said. “But if we’re still not getting the right treatment to the right patient at the right time, then we’re not doing a good enough job.”

“Colorectal cancer is universally screened for and develops fairly slowly. So if someone is plugged into the health care system, the chances are very high that we will detect it and they will get the appropriate evaluation and work-up,” he added. “The fact that we found patients who are not getting that suggests that there is an opportunity to improve the care we deliver to patients, even before they get to the surgical episode.”

Howard points to patient navigators and targeted community outreach as proven strategies to help reduce disparities in cancer care and believes the state of Michigan, with its network of collaborative quality initiatives, is well positioned to incorporate these solutions into future projects.

Howard was the creative director for Annals of Surgery, where this study was published, but was not involved in the review process for this paper.

Paper cited: “Racial and Ethnic Differences in Elective vs. Emergency Surgery for Colorectal Cancer,” Annals of Surgery. DOI: 10.1097/SLA.0000000000005667

More Articles About: Race and Ethnicity Colorectal Cancer Cancer Surgery Future Think All Research Topics Health Screenings Demographics Health Care Quality Hospitals & Centers
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories
Health Lab
How to protect your eyes during the total solar eclipse
A Michigan Medicine ophthalmologist and retinal surgeon shares advice for viewing the total solar eclipse safely, including what to look for in eye protection.
heart organ yellow blue
Health Lab
Around 10% of deaths from coronary stenting, balloon angioplasty are preventable
Around 10% of all deaths following percutaneous coronary intervention are potentially preventable, a study led by Michigan Medicine finds.
Photo of two silhouettes in a hallway
Health Lab
Most new doctors face some form of sexual harassment, even after #MeToo
Sexual harassment of all kinds is a common experience among first-year medical residents, also known as interns, especially those in surgical specialties, but it may be declining.
Health Lab
Father’s cancerous brain tumor found weeks after the birth of his daughter
Father’s cancerous brain tumor found weeks after the birth of his daughter
Spilled pills next to a stethoscope and pile of cash
Health Lab
Drug pricing program improved prostate cancer treatment adherence
Socially vulnerable patients were more likely to stick with oral medications when treated at a hospital participating in 340B program, suggesting these hospitals may have more resources to help patients.
Health Lab
Same patient. Different visit. Different race and ethnicity?
Data on the race and ethnicity of patients underpins efforts to reduce health care disparities, but a study shows inconsistent recording in emergency departments