Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage

Abstract Background There are well‐established disparities in colorectal cancer (CRC) outcomes between White and Black patients; however, assessments of CRC disparities for other racial/ethnic groups are limited. Methods The Surveillance, Epidemiology, and End Results database identified patients ag...

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Main Authors: Kristin M. Primm, Andrea Joyce Malabay, Taylor Curry, Shine Chang
Format: Article
Language:English
Published: Wiley 2023-07-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.6105
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author Kristin M. Primm
Andrea Joyce Malabay
Taylor Curry
Shine Chang
author_facet Kristin M. Primm
Andrea Joyce Malabay
Taylor Curry
Shine Chang
author_sort Kristin M. Primm
collection DOAJ
description Abstract Background There are well‐established disparities in colorectal cancer (CRC) outcomes between White and Black patients; however, assessments of CRC disparities for other racial/ethnic groups are limited. Methods The Surveillance, Epidemiology, and End Results database identified patients aged 50–74 years with CRC adenocarcinoma from 2000 to 2019. Trends in age‐adjusted incidence rates were computed by stage at diagnosis and subsite across five broad race/ethnic groups (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AIAN], and Hispanic) and four API subgroups (East Asian, Southeast Asian, South Asian, and Pacific Islander) Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox proportional hazards models assessed differences in cause‐specific survival (CSS). Results Hispanic, AIAN, Southeast Asian, Pacific Islander, and Black patients were 3% to 28% more likely than Whites to be diagnosed with distant stage CRC, whereas East Asian and South Asians had similar or lower risk of distant stage CRC. From Cox regression analysis, Black, AIAN, and Pacific Islanders also experienced worse CSS, while East Asian and South Asian patient groups experienced better CSS. No significant differences in CSS were observed among Hispanic, Southeast Asian, and White patients. When stratified by stage, Black patients had worse CSS across all stages (early, hazard ratio (HR) = 1.38; regional, HR = 1.22; distant, HR: 1.07, p < 0.05 for all). Conclusion Despite advances in CRC screening, treatment and early detection efforts, marked racial/ethnic disparities in incidence, stage at diagnosis, and survival persist. Findings demonstrate the extent to which aggregating heterogenous populations masks significant variability in CRC outcomes within race/ethnic subgroups.
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spelling doaj.art-9f1d665c9290483684a6db38c85885d62023-07-20T12:57:16ZengWileyCancer Medicine2045-76342023-07-011213147671478010.1002/cam4.6105Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stageKristin M. Primm0Andrea Joyce Malabay1Taylor Curry2Shine Chang3Department of Epidemiology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Epidemiology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Epidemiology The University of Texas MD Anderson Cancer Center Houston Texas USADepartment of Epidemiology The University of Texas MD Anderson Cancer Center Houston Texas USAAbstract Background There are well‐established disparities in colorectal cancer (CRC) outcomes between White and Black patients; however, assessments of CRC disparities for other racial/ethnic groups are limited. Methods The Surveillance, Epidemiology, and End Results database identified patients aged 50–74 years with CRC adenocarcinoma from 2000 to 2019. Trends in age‐adjusted incidence rates were computed by stage at diagnosis and subsite across five broad race/ethnic groups (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AIAN], and Hispanic) and four API subgroups (East Asian, Southeast Asian, South Asian, and Pacific Islander) Multivariable logistic regression evaluated associations between race/ethnicity and diagnosis stage. Multivariable Cox proportional hazards models assessed differences in cause‐specific survival (CSS). Results Hispanic, AIAN, Southeast Asian, Pacific Islander, and Black patients were 3% to 28% more likely than Whites to be diagnosed with distant stage CRC, whereas East Asian and South Asians had similar or lower risk of distant stage CRC. From Cox regression analysis, Black, AIAN, and Pacific Islanders also experienced worse CSS, while East Asian and South Asian patient groups experienced better CSS. No significant differences in CSS were observed among Hispanic, Southeast Asian, and White patients. When stratified by stage, Black patients had worse CSS across all stages (early, hazard ratio (HR) = 1.38; regional, HR = 1.22; distant, HR: 1.07, p < 0.05 for all). Conclusion Despite advances in CRC screening, treatment and early detection efforts, marked racial/ethnic disparities in incidence, stage at diagnosis, and survival persist. Findings demonstrate the extent to which aggregating heterogenous populations masks significant variability in CRC outcomes within race/ethnic subgroups.https://doi.org/10.1002/cam4.6105colorectal cancerracial/ethnic disparitiesSEERstage at diagnosissubsitetime trends
spellingShingle Kristin M. Primm
Andrea Joyce Malabay
Taylor Curry
Shine Chang
Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
Cancer Medicine
colorectal cancer
racial/ethnic disparities
SEER
stage at diagnosis
subsite
time trends
title Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
title_full Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
title_fullStr Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
title_full_unstemmed Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
title_short Who, where, when: Colorectal cancer disparities by race and ethnicity, subsite, and stage
title_sort who where when colorectal cancer disparities by race and ethnicity subsite and stage
topic colorectal cancer
racial/ethnic disparities
SEER
stage at diagnosis
subsite
time trends
url https://doi.org/10.1002/cam4.6105
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