Background: There are a variety of treatments available for patients with stage IV colon cancer. Chemotherapy is the usual treatment, with greater amounts of surgery being associated with more aggressive hospitals. Income can play a role in the type of treatment a patient receives, or if they even receive treatment at all (Baldwin et al. 2005).
Methods: First course treatment received by stage IV colon cancer patients of Veterans Affair Hospitals (VAH) and all other hospital types were compared using the National Cancer Data Base (NCDB). Patient’ 2012 income and type of treatment provided were examined. Treatment types included chemotherapy, surgery, no treatment, etc. Data from 45 VAH with 2,667 patients and 1,543 non-VA affiliated hospitals with 144,575 patients were utilized. Chi-squared analysis was conducted to calculate statistical significance.
Results: The NCDB reveals noticeable differences between VAH and all other hospitals in percentages of stage IV colon cancer patients receiving treatment. 25.3% of VAH patients received no treatment while 16.9% of patients at all other hospitals received no treatment (P < .05). More VAH patients received solely chemotherapy compared to patients at other hospitals (21.2% vs 15.9%, P < .05). VAH patients had less surgery compared to patients at all other hospitals (47.2% vs 59.4%, P < .05). These effects were present at all income levels.
Implications: VAH patients were more likely to receive no treatment compared to patients at all other hospitals. Furthermore, VAH patients were less likely to receive aggressive surgical care compared to other hospitals. These results imply that VAH patients are more likely to receive no treatment in comparison to other hospitals, as well as less likely to receive aggressive care when treatment is given. Differences in care seen between hospital types were not influenced by income.
