New findings presented at the American College of Gastroenterology revealed significant racial and socioeconomic disparities in the stage of diagnosis for early-onset colorectal cancer (EOCRC), according to a large retrospective analysis using the SEER 17 database.

The study evaluated 41,230 cases of EOCRC diagnosed between 2000 and 2020 in patients aged 20–49 years. Researchers analyzed the incidence rate ratio (IRR) for tumor stages at diagnosis—localized, regional, and distant—across race, ethnicity, sex, household income, and urban versus non-metropolitan residence. 

Key findings include disproportionately higher IRRs for all three tumor stages in Black patients compared to White patients, as well as higher IRRs for localized and distant stages in American Indian/Alaskan Native (AI/AN) patients. Asian/Pacific Islander (API) patients had elevated IRRs for localized cancer, while Hispanic patients exhibited lower IRRs for all stages compared to White patients. 

Socioeconomic factors also played a significant role. Patients from lower-income households and non-metropolitan counties were more likely to be diagnosed at later stages of EOCRC. Notably, Black, AI/AN, and Hispanic patients had a higher proportion of distant-stage diagnoses compared to White patients, highlighting disparities in early detection. 

The authors emphasize that while colorectal cancer screening has reduced overall incidence, the rising prevalence of EOCRC and its inequitable burden across racial and socioeconomic groups demand action. Increasing awareness, promoting early screening, and enhancing healthcare accessibility for high-risk populations may help mitigate these disparities and improve outcomes. 

Reference

Goyal R, Sachdeva K, Dhaliwal L, et al. Impact of racial disparities and socioeconomic factors on tumor stage at diagnosis in early-onset colorectal cancer: A SEER database study. The American Journal of Gastroenterology. 2024;119(10S):S291-S292. DOI: 10.14309/01.ajg.0001031012.86011.b1b1

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