Journal Article

Outcome disparities in colorectal cancer: a SEER-based comparative analysis of racial subgroups

Al-Husseini, Muneer J., Gad, Mohamed M., Elmatboly, Abdelmagid M., Hilal, Talal, Jazieh, Khalid A., Saad, Anas M., Rachid, Ahmad, Ruhban, Inas A.

2019

Overview

Purpose Previous studies of ethnic disparities in colorectal cancer (CRC) have focused mainly on patients of Caucasian and African-American descent. We aimed to evaluate outcomes for a range of races, representing a broader demographic of the US population. Methods The Surveillance, Epidemiology, and End Results database was queried to identify patients with CRC diagnosed between 1994 and 2014. We performed unadjusted Kaplan-Meier test and multivariable covariate-adjusted Cox models to calculate the overall and CRC-specific survival of patients according to their race. Results We identified 401,723 patients diagnosed with CRC between 1994 and 2014. Overall survival (OS) and CRC-specific survival were compared across different races stratified by age, sex, marital status, disease stage and grade, and undergoing surgery as a treatment. Overall, Asian/Pacific Islanders and Hispanics had improved CRC-specific survival compared to Whites (HR = 0.873, 95%CI 0.853–0.893, P  < .001, and HR = 0.958, 95%CI 0.937–0.979, P  < .001, respectively). Blacks had the worst CRC-specific survival outcomes when compared to Whites (HR = 1.215, 95%CI 1.192–1.238, P  < .001). Racial disparity persisted when looking at two different time periods (1994–2003 and 2004–2014). Conclusions Asians/Pacific Islanders have improved outcomes from CRC compared to other races. Multifactorial, including genetic, environmental, and socioeconomic factors appear to influence outcomes and need to be addressed separately in order to reduce racial disparities among patients with CRC.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: African Americans / Age / Analysis / Asian people / Cancer / Cancer therapies / Chemotherapy / Colorectal cancer / Comparative analysis / Epidemiology / Females / Gastroenterology / Health aspects / Health risk assessment / Hepatology / Hispanic Americans / Inequality / Internal Medicine / Marital status / Medical diagnosis / Medicine / Medicine & Public Health / Mortality / Native North Americans / Oncology, Experimental / Original Article / Pacific Islander people / Patients / Population / Proctology / Race / Races / Racial differences / Radiation / Socioeconomic factors / Socioeconomics / Software / Surgery / Survival / Survival analysis