C0170 - Disparities in Survival and Stage at Diagnosis in Ethnic and Racial Minorities Diagnosed With Early Onset Colorectal Cancer

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Roshan Panchanathan, MD

University of Washington
Seattle, WA

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

Introduction: Although the overall incidence of early onset Colorectal Cancer (eoCRC) is increasing, the incidence remains higher among Black and Hispanic patients than non-Hispanic whites. The aim of this study was to examine racial and ethnic disparities in the stage at diagnosis and survival of patients with 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 aged <50 years diagnosed with eoCRC from 2000-2017. Selected variables of interest included race/ethnicity, stage at diagnosis, and survival time. Survival analysis was limited to patients diagnosed between 2000-2012 to include minimum 5-year survival data. The study was certified exempt by the University of Washington IRB.

Results: 71,651 patients were identified of whom 58.5% were non-Hispanic White (NHW) patients and 41.5% were racial/ethnic minorities. 24,229 patients had localized (stage I-IIc), 26,947 patients had regional (stage IIIa-c), and 17,805 patients had distant (stage IVa/b) eoCRC at diagnosis. Patients from racial/ethnic minorities were significantly more likely to be diagnosed with distant eoCRC compared to NHW patients (Table 1) (p< 0.01). These differences were greatest for non-Hispanic Black (NHB) patients. Overall as well as stage-specific 1-year and 5-year survival was significantly shorter in racial/ethnic minorities (Figure 1) (p< 0.01). These differences were again greatest in NHB patients.

Discussion: Significant differences in stage at diagnosis were seen between NHW and racial/ethnic minorities with eoCRC. Significant racial/ethnic differences were also seen in overall median survival and median survival at all stages of diagnosis. For both stage and survival, the greatest differences were seen in NHB patients followed by American Indian/Alaska Native patients. Further study is needed to understand the reason for these disparities.

Figure: Figure 1 - Kaplan Meier curve depicting overall 5-year survival of patients with eoCRC stratified by race/ethnicity.

Stage	Race/Ethnicity	Portion of Racial/Ethnic Cohort	1-year Survival Rate	5-year Survival Rate
Overall
(n = 48,987)	All Races/Ethnicities	100%	89.3%	66.6%
	Non-Hispanic White	100%	89.8%	68.4%
	Non-Hispanic Black	100%	85.6%	57.8%
	Hispanic (all races)	100%	89.3%	66.0%
	Asian of Pacific Islander	100%	91.0%	67.8%
	American Indian/Alaska Native	100%	87.4%	61.5%
	Unknown	100%	98.7%	97.4%
Localized
(n = 16,510)	All Races/Ethnicities	33.7%	98.2%	91.6%
	Non-Hispanic White	34.3%	98.4%	92.3%
	Non-Hispanic Black	32.5%	97.1%	87.8%
	Hispanic (all races)	31.9%	97.9%	90.6%
	Asian of Pacific Islander	32.4%	99.2%	93.5%
	American Indian/Alaska Native	31.5%	95.3%	85.8%
	Unknown	13.7%	99.6%	99.6%
Regional
(n = 18,706)	All Races/Ethnicities	38.2%	95.5%	74.9%
	Non-Hispanic White	38.8%	95.6%	76.7%
	Non-Hispanic Black	35.0%	93.8%	66.3%
	Hispanic (all races)	38.7%	95.7%	74.2%
	Asian or Pacific Islander	40.5%	96.4%	75.7%
	American Indian/Alaska Native	36.3%	94.0%	74.1%
	Unknown	13.7%	100%	96.2%
Distant
(n = 12,011)	All Races/Ethnicities	24.5%	67.6%	19.3%
	Non-Hispanic White	23.7%	68.1%	20.2%
	Non-Hispanic Black	28.2%	62.2%	12.2%
	Hispanic (all races)	25.5%	69.3%	23.1%
	Asian or Pacific Islander	23.8%	71.2%	19.8%
	American Indian/Alaska Native	26.9%	68.3%	15.1%
	Unknown	3.7%	85.5%	64.3%
Unstaged
(n = 1,760)	All Races/Ethnicities	3.6%	87.2%	67.0%
	Non-Hispanic White	3.2%	87.2%	67.9%
	Non-Hispanic Black	4.3%	84.7%	60.9%
	Hispanic (all races)	3.9%	87.4%	63.3%
	Asian or Pacific Islander	12.4%	86.3%	65.1%
	American Indian/Alaska Native	5.1%	97.5%	66.7%
	Unknown	20.3%	97.4%	97.4%

Table: Table 1 - Stage at diagnosis, 1-year and 5 year survival rate of patients diagnosed with eoCRC stratified by race/ethnicity.

Disclosures:

Roshan Panchanathan indicated no relevant financial relationships.

J. Alexander Torres indicated no relevant financial relationships.

Cynthia Ko indicated no relevant financial relationships.

Roshan Panchanathan, MD, J. Alexander Torres, MD, Cynthia Ko, MD, MS. C0170 - Disparities in Survival and Stage at Diagnosis in Ethnic and Racial Minorities Diagnosed With Early Onset Colorectal Cancer, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.