完全新辅助治疗彻底改变了局部晚期直肠癌的治疗，并迅速成为新的护理标准。然而，来自所有种族和族裔群体的患者是否都能平等地获得这些潜在的益处仍然未知。我们使用加州癌症登记处，确定了 2010 年至 2020 年在加州诊断出患有局部晚期直肠癌并接受新辅助化疗和放疗的所有成年人。我们使用逻辑回归来估计每个种族和民族群体接受总体新辅助治疗相对于传统放化疗的预测概率，并使用时间-种族交互作用来评估随着时间的推移获得总体新辅助治疗的趋势。我们还使用 Kaplan-Meier 图和 Cox 比例风险模型比较了不同种族和民族的生存率以及总新辅助治疗状态。总共有 6,856 名患者符合纳入标准。总体而言，2010 年有 36.6% 的患者接受了全面新辅助治疗，而 2020 年为 66.3%。拉丁裔患者接受全面新辅助治疗的可能性明显低于非拉丁裔白人患者；然而，随着时间的推移，不同种族和族裔群体的新辅助治疗总量增长率没有差异。与非拉丁裔白人患者相比，非拉丁裔黑人患者的风险调整生存期似乎较低，尽管接受全面新辅助治疗的患者并非如此。随着时间的推移，在加利福尼亚州，接受全面新辅助治疗的机会显着增加，但比率没有明显差异种族和族裔群体之间的增长。我们没有发现证据表明接受新辅助治疗的患者的生存率存在种族或民族差异，这表明增加获得高质量癌症护理的机会也可能改善健康公平。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Total neoadjuvant therapy has revolutionized the treatment of locally advanced rectal cancer and quickly become the new standard of care. Whether patients from all racial and ethnic groups have had equal access to these potential benefits, however, remains unknown.We identified all adults diagnosed with locally advanced rectal cancer in California who underwent neoadjuvant chemotherapy and radiation from 2010 to 2020 using the California Cancer Registry. We used logistic regression to estimate the predicted probability of receiving total neoadjuvant therapy as opposed to traditional chemoradiotherapy for each racial and ethnic group and used a time-race interaction to evaluate trends in access to total neoadjuvant therapy over time. We also compared survival by racial and ethnic group and total neoadjuvant therapy status using Kaplan-Meier plots and Cox proportional hazards models.In total, 6,856 patients met inclusion criteria. Overall, 36.6% of patients received total neoadjuvant therapy in 2010 compared with 66.3% in 2020. Latino patients were significantly less likely than non-Latino White patients to undergo total neoadjuvant therapy ; however, there was no difference in the rate of growth in total neoadjuvant therapy over time between racial and ethnic groups. Non-Latino Black patients appeared to have lower risk-adjusted survival compared with non-Latino White patients, although not among patients who underwent total neoadjuvant therapy .Access to total neoadjuvant therapy has increased significantly over time in California with no apparent difference in the rate of growth between racial and ethnic groups. We found no evidence of racial or ethnic disparities in survival among patients treated with total neoadjuvant therapy, suggesting that increasing access to high-quality cancer care may also improve health equity.Copyright © 2024 Elsevier Inc. All rights reserved.