Table 1.
Surgery Type and Adjusted Odds of Receiving LE and Irradiation for Stage I Rectal Cancer (1998-2010 incident cases)*
| Characteristic | Procedure |
LE |
RT |
||||||
|---|---|---|---|---|---|---|---|---|---|
| LE (n = 18,961) |
Proctectomy (n = 27,043) |
P | |||||||
| No. | % | No. | % | OR | 95% CI | OR | 95% CI | ||
| Sex | < .001 | ||||||||
| Male | 9,889 | 39.6 | 15,095 | 60.4 | 1.00 | 1.00 | |||
| Female | 9,072 | 43.2 | 11,948 | 56.8 | 1.11 | 1.05 to 1.16 | 0.87 | 0.81 to 0.94 | |
| Age, years | < .001 | ||||||||
| < 30 | 98 | 52.7 | 88 | 47.3 | 1.03 | 0.70 to 1.51 | 0.79 | 0.41 to 1.53 | |
| 30 to 39 | 432 | 43.6 | 560 | 56.5 | 1.01 | 0.85 to 1.20 | 1.19 | 0.94 to 1.52 | |
| 40 to 49 | 1,596 | 39.4 | 2,459 | 60.6 | 1.00 | 0.91 to 1.10 | 1.18 | 1.04 to 1.35 | |
| 50 to 59 | 4,155 | 41.1 | 5,946 | 58.9 | 1.00 | 1.00 | |||
| 60 to 69 | 4,510 | 38.5 | 7,195 | 61.5 | 1.02 | 0.95 to 1.10 | 0.96 | 0.86 to 1.07 | |
| 70 to 79 | 4,771 | 40.1 | 7,117 | 59.9 | 1.22 | 1.12 to 1.33 | 0.79 | 0.70 to 0.90 | |
| 80 to 89 | 2,983 | 46.9 | 3,381 | 53.1 | 1.76 | 1.59 to 1.94 | 0.45 | 0.39 to 0.53 | |
| ≥ 90 | 416 | 58.4 | 297 | 41.7 | 2.78 | 2.27 to 3.41 | 0.18 | 0.11 to 0.29 | |
| Race | < .001 | ||||||||
| White | 16,146 | 40.1 | 24,153 | 59.9 | 1.00 | 1.00 | |||
| Black | 1,793 | 52.0 | 1,654 | 48.0 | 1.39 | 1.27 to 1.52 | 0.98 | 0.86 to 1.13 | |
| Native American | 35 | 34.7 | 66 | 65.4 | 0.76 | 0.45 to 1.27 | 0.99 | 0.47 to 2.05 | |
| Asian | 568 | 45.0 | 695 | 55.0 | 0.93 | 0.80 to 1.08 | 0.85 | 0.67 to 1.08 | |
| Other/unknown | 419 | 46.9 | 475 | 53.1 | 1.20 | 1.01 to 1.42 | 0.73 | 0.55 to 0.97 | |
| Insurance | < .001 | ||||||||
| Uninsured | 354 | 42.9 | 472 | 57.1 | 1.35 | 1.13 to 1.61 | 0.83 | 0.64 to 1.06 | |
| Private | 2,460 | 38.5 | 3,938 | 61.6 | 1.00 | 1.00 | |||
| Medicaid | 502 | 43.8 | 643 | 56.2 | 1.02 | 0.87 to 1.20 | 0.88 | 0.70 to 1.11 | |
| Medicare | 9,184 | 41.2 | 12,786 | 58.8 | 1.01 | 0.95 to 1.08 | 0.93 | 0.84 to 1.02 | |
| No high school diploma, % | .031 | ||||||||
| < 14 | 2,877 | 42.2 | 3,949 | 57.9 | 1.00 | 1.00 | |||
| 14 to 19.9 | 4,129 | 40.4 | 6,084 | 59.6 | 0.96 | 0.90 to 1.02 | 1.03 | 0.94 to 1.13 | |
| 20 to 28.9 | 4,318 | 40.0 | 6,354 | 60.0 | 0.92 | 0.86 to 0.98 | 1.18 | 1.07 to 1.29 | |
| ≥ 29 | 6,618 | 42.0 | 9,264 | 58.0 | 1.00 | 0.93 to 1.07 | 1.17 | 1.05 to 1.30 | |
| Rural location | .05 | ||||||||
| Yes | 363 | 38.0 | 589 | 62.0 | 0.99 | 0.84 to 1.16 | 0.91 | 0.71 to 1.16 | |
| No | 17,526 | 41.0 | 24,913 | 59.0 | 1.00 | 1.00 | |||
| Tumor grade | < .001 | ||||||||
| Well differentiated | 3,496 | 50.0 | 3,492 | 50.0 | 1.00 | 1.00 | |||
| Moderately differentiated | 9,968 | 34.0 | 19,182 | 66.0 | 0.69 | 0.65 to 0.74 | 1.38 | 1.23 to 1.54 | |
| Poorly differentiated | 1,236 | 35.6 | 2,234 | 61.4 | 0.80 | 0.72 to 0.88 | 2.10 | 1.81 to 2.44 | |
| Unknown | 4,261 | 66.6 | 2,135 | 33.4 | 1.62 | 1.48 to 1.77 | 0.72 | 0.61 to 0.85 | |
| T classification | < .001 | ||||||||
| pT1 | 9,431 | 46.5 | 10,854 | 53.5 | 1.00 | 1.00 | |||
| pT2 | 2,920 | 16.8 | 14,461 | 83.2 | 0.26 | 0.25 to 0.27 | 3.96 | 3.64 to 4.30 | |
| Margins | < .001 | ||||||||
| Positive or unknown | 4,494 | 23.7 | 1,430 | 5.3 | 3.14 | 2.76 to 3.58 | |||
| Negative | 14,467 | 76.3 | 25,613 | 94.7 | 1.00 | ||||
| Surgery | |||||||||
| Local excision | 5.19 | 4.78 to 5.63 | |||||||
| Proctectomy | 1.00 | ||||||||
| Comorbidity score* | < .001 | ||||||||
| 0 | 8,925 | 45.5 | 10,708 | 54.5 | 1.00 | 1.00 | |||
| 1 | 1,610 | 37.6 | 2,676 | 62.4 | 0.76 | 0.70 to 0.83 | 0.83 | 0.73 to 0.96 | |
| 2 | 492 | 39.2 | 764 | 60.8 | 0.81 | 0.70 to 0.93 | 0.67 | 0.52 to 0.86 | |
Abbreviations: LE, local excision; OR, odds ratio; RT, radiation therapy.
*
ORs for comorbidity score based on subset analysis using 2003 to 2010 incident patient cases only (n = 25,175).