Sex differences in hospital readmission among colorectal cancer patients
- Juan Ramon González1,
- Esteve Fernandez1,2,
- Víctor Moreno3,
- Josepa Ribes3,
- Mercè Peris1,
- Matilde Navarro4,
- Maria Cambray5,
- Josep Maria Borràs1,2
- 1Cancer Prevention and Control Unit, Institut Català d’Oncologia, Barcelona, Spain
- 2Department of Public Health, Universitat de Barcelona, Spain
- 3Epidemiology and Cancer Registry Unit, Institut Català d’Oncologia
- 4Medical Oncology Department, Institut Català d’Oncologia
- 5Radiotherapy Oncology Department, Institut Català d’Oncologia
- Correspondence to: Dr E Fernandez Cancer Prevention and Control Unit, Institut Català d’Oncologia, Avda. Gran Vía s/n, km 2,7, 08907 L’Hospitalet de Llobregat, Barcelona, Spain;
- Accepted 28 December 2004
Background: While several studies have analysed sex and socioeconomic differences in cancer incidence and mortality, sex differences in oncological health care have been seldom considered.
Objective: To investigate sex based inequalities in hospital readmission among patients diagnosed with colorectal cancer.
Design: Prospective cohort study.
Setting: Hospital Universitary in L’Hospitalet (Barcelona, Spain).
Participants: Four hundred and three patients diagnosed with colorectal between January 1996 and December 1998 were actively followed up until 2002.
Main outcome measurements and methods: Hospital readmission times related to colorectal cancer after surgical procedure. Cox proportional model with random effect (frailty) was used to estimate hazard rate ratios and 95% confidence intervals of readmission time for covariates analysed.
Results: Crude hazard rate ratio of hospital readmission in men was 1.61 (95% CI 1.21 to 2.15). When other significant determinants of readmission were controlled for (including Dukes’s stage, mortality, and Charlson’s index) a significant risk of readmission was still present for men (hazard rate ratio: 1.52, 95% CI 1.17 to 1.96).
Conclusions: In the case of colorectal cancer, women are less likely than men to be readmitted to the hospital, even after controlling for tumour characteristics, mortality, and comorbidity. New studies should investigate the role of other non-clinical variable such as differences in help seeking behaviours or structural or personal sex bias in the attention given to patients.
Funding: this study was partially funded by a grant from the Marató of TV3 (contract 48/95), the Spanish Ministry of Health (research grants from the Instituto de Salud Carlos III and Fondo de Investigación Sanitaria: FIS 96/0797, FIS 00/0027, FIS 01/1264, SAF 00/81, RTICC C03/10, and RCESP C03/09).
Conflicts of interest: none declared.