Racial, Ethnic Disparities Found in Early-Onset CRC Survival

Black, Hispanic, and Asian race/ethnicity were associated with higher all-cause mortality than White race among patients diagnosed with early-onset colorectal cancer (CRC), researchers reported.

The investigators used the National Cancer Institute’s Surveillance, Epidemiology, and End Results cancer registries to identify patients aged 20 to 49 years who were diagnosed with CRC between January 1, 1992, and December 31, 2013.

For each group, the study team estimated 5-year relative survival overall and by sex, tumor site, and stage at diagnosis and compared 5-year relative survival during the periods 1992-2002 and 2003-2013. “We also used Cox proportional hazards regression models to examine the association of race/ethnicity and all-cause mortality, adjusting for age at diagnosis, sex, county type (urban vs. rural), county-level median household income, tumor site, and stage at diagnosis,” the researchers wrote.

Among 33,777 patients diagnosed with early-onset CRC, 58.5% were White, 14.0% were Black, 13.0% were Asian, and 14.5% were Hispanic). The five-year relative survival rate ranged from 57.6% among Black patients to 69.1% among White patients. Relative 5-year survival improved only among White patients during 2003-2013 compared to 1992-2002 . No improvement was seen among Black, Asian, or Hispanic patients.

“This pattern was similar by sex, tumor site, and stage at diagnosis,” the authors wrote. “In adjusted analysis, Black (aHR 1.42, 95% CI 1.36, 1.49), Asian (aHR 1.06, 95% CI 1.01, 1.12), and Hispanic (aHR 1.16, 95% CI 1.10, 1.21) race/ethnicity were associated with all-cause mortality.”

“Our study adds to the well-documented disparities in CRC in older adults by demonstrating persistent racial/ethnic disparities in relative survival and all-cause mortality in patients with early-onset CRC,” the investigators concluded.

—Rebecca Mashaw

Reference:

Zaki TA, Liang PS, May FP, Murphy CC. Racial and ethnic disparities in early-onset colorectal cancer survival. Clin Gastroenterol Hepatol. Published online June 15, 2022. DOI:https://doi.org/10.1016/j.cgh.2022.05.035