B0172 - Racial and Ethnic Disparities in Treatment for Early Onset Colorectal Cancer

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

J. Alexander Torres, MD

University of Washington
Seattle, WA

J. Alexander Torres, MD, Roshan Panchanathan, MD, Cynthia Ko, MD, MS
University of Washington, Seattle, WA

Introduction:

Incidence of early onset Colorectal Cancer (eoCRC), defined as colorectal cancer diagnosed before the age of 50, is on the rise, with known racial and ethnic disparities in risk. The aim of this study was to examine racial and ethnic disparities in the treatment of eoCRC.

Methods: We conducted a retrospective cohort study using the National Cancer Institute’s Surveillance, Epidemiology, and End Results 18 Registries (SEER 18) Program Research Plus database. We included all patients younger than 50 years old diagnosed with eoCRC from 2000-2017. Selected variables of interest included race/ethnicity, stage at diagnosis, and treatment (chemotherapy, radiation therapy, and surgery) received. Statistical analysis was performed using International Business Machines (IBM) SPSS Statistics software. Limitations of the SEER Research Plus database include the capture of only first course treatment as well as the possibility of not capturing chemotherapy or radiation events in some patients. This limitation is not present for surgical treatment events. The study was certified exempt by the University of Washington IRB.

Results: 71,651 patients were identified, of whom 24,229 patients had localized (stage I-IIc) eoCRC. 26,947 patients had regional (stage IIIa-c) eoCRC. 17,805 patients had distant (stage IVa/b) eoCRC (Table 1). Patients from racial/ethnic minorities with localized disease received surgery significantly less frequently than non-Hispanic Whites (p< 0.01), with the greatest differences seen for non-Hispanic Black patients and Hispanic patients. Patients from minority backgrounds with distant disease received chemotherapy significantly less frequently than non-Hispanic Whites (p< 0.01). These differences were greatest for non-Hispanic Black patients and American Indian/Alaska Native patients. There was no significant difference in radiation therapy frequency among patients with rectal cancer.

Discussion:

Significant differences in treatment received were seen between non-Hispanic Whites and racial/ethnic minorities with eoCRC. Non-Hispanic Black, Hispanic, and American Indian/Alaska native patients were at greatest risk of not receiving surgery for treatment of localized eoCRC or chemotherapy for distant disease. Further study is needed to understand the reason for these disparities.

Stage	Race/Ethnicity	Surgery (n = 71,651)	Chemotherapy (n= 71,651)	Radiation - Rectal Cancers Only (n = 27,948)
Localized
	Non-Hispanic White	95.30%	20.33%	29.31%
	Hispanic	92.68%	19.42%	24.48%
	American Indian/Alaska Native	94.09%	25.32%	37.07%
	Asian/Pacific Islander	95.59%	19.54%	23.59%
	Non-Hispanic Black	93.01%	16.80%	19.21%
	Unknown	81.51%	3.39%	3.37%
Regional
	Non-Hispanic White	96.73%	76.04%	74.10%
	Hispanic	94.84%	73.57%	74.15%
	American Indian/Alaska Native	93.95%	78.63%	82.47%
	Asian/Pacific Islander	96.35%	77.44%	74.53%
	Non-Hispanic Black	96.03%	70.06%	71.92%
	Unknown	94.68%	54.26%	67.74%
Distant
	Non-Hispanic White	66.29%	80.81%	40.70%
	Hispanic	59.93%	78.02%	39.83%
	American Indian/Alaska Native	59.24%	77.72%	43.84%
	Asian/Pacific Islander	65.43%	81.88%	42.93%
	Non-Hispanic Black	61.13%	74.38%	38.53%
	Unknown	75.00%	67.86%	45.45%

Table: Table 1 - Portion of patients receiving specified treatment modalities stratified by stage of eoCRC and race.

Disclosures:

J. Alexander Torres indicated no relevant financial relationships.

Roshan Panchanathan indicated no relevant financial relationships.

Cynthia Ko indicated no relevant financial relationships.

J. Alexander Torres, MD, Roshan Panchanathan, MD, Cynthia Ko, MD, MS. B0172 - Racial and Ethnic Disparities in Treatment for Early Onset Colorectal Cancer, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.