Improving Adequacy of Colorectal Cancer Care for African Americans (CEED Project 2)

Also known as

Colon Cancer Patterns of Care in Chicago Study


Colorectal cancer (CRC) is the second most common cancer among African American women and the third most common cancer for African American men. The African American community also bears a disproportionate burden of this disease, with the highest mortality rate of any racial/ethnic group from this cancer. Much of the disparity in mortality is likely due to later stage at diagnosis, which in turn depends on whether the cancer was detected earlier through screening or, more commonly, later, after symptoms appear. Use of colorectal cancer screening is low overall and lower among African Americans than whites. Colonoscopy is generally considered the gold standard for colon cancer screening because the procedure allows for viewing the entire colon and removing pre-malignant and malignant tumors. Yet African Americans may underutilize this procedure due to underinsurance and fewer financial resources to pay for this more expensive test, or less knowledge regarding screening options.

Patient delay in presenting symptoms for medical evaluation (presentation delay), and the amount of time spent in the system before beginning treatment may also contribute to later stage at diagnosis and less treatable colon cancer. In addition, adjuvant chemotherapy can increase survival for patients with later-stage colon cancer, yet many patients who should receive chemotherapy do not, and prior studies provide evidence for both socioeconomic and racial disparities in receipt of chemotherapy.

The goals of this study, the Colon Cancer Patterns of Care in Chicago (CCPCC) study, are to identify factors that could be intervened upon to improve adequacy of care for colon cancer and reduce the stage and mortality disparities. This multi-institutional study involves the collaboration of several health care institutions, including the University of Illinois, Advocate Health Care, John H. Stroger Hospital of Cook County, Rush Medical Center, Northwestern Memorial Hospital, and the University of Chicago.

Patients are eligible for the study if they receive a diagnosis of a first primary invasive colon cancer between the ages of 30 and 79 and live in Cook, DuPage, Lake or Will County in Illinois, or Lake County, Indiana, at the time of diagnosis. The study will involve interviews of 650 newly diagnosed African-American and non-Hispanic white patients with colon cancer, and medical record abstractions to obtain information specifically related to screening, diagnosis and treatment for colon cancer.

Download our study recruitment brochure.

This study is a research project within a center grant:

Center of Excellence in Eliminating Disparities
Funding Agency

National Center on Minority Health and Health Disparities of the National Institutes of Health (Grant No. P60MD003424)


Principal investigator
Garth H. Rauscher, PhD


Carol Estwing Ferrans, PhD, RN, FAAN

Start date
End date
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About this grant

The funding period of this grant was extended by one year with no additional money. 

Related publications

Jones LA, Ferrans CE, Polite BN, Brewer KC, Maker AV, Pauls HA, Rauscher GH. Examining racial disparities in colon cancer clinical delay in the Colon Cancer Patterns of Care in Chicago study. Ann Epidemiol. 2017 Nov;27(11):731-738.e1.