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S0215 Gender and Racial Disparities in Colorectal Cancer Incidence and Survival: A Population-Based Study

2020; Lippincott Williams & Wilkins; Volume: 115; Issue: 1 Linguagem: Inglês

10.14309/01.ajg.0000702908.72527.5f

1572-0241

Daryl Ramai, Haluk Tarık Kani, Ogenetega Madedor, Olivia W. Brooks, Andrew Ofosu, Mohamed Barakat, Banreet Dhindsa, Saurabh Chandan, Amaninder Dhaliwal, Denzil Etienne, Sam S. Chang, Douglas G. Adler, Madhavi Reddy,

Colorectal Cancer Treatments and Studies

INTRODUCTION: Colorectal cancer (CRC) is the third common cause of cancer death in the US. The incidence of CRC is higher in minority racial and ethnic groups. Traditionally, CRC has had a higher mortality rate in men when compared to women. However, studies assessing trends among sex and racial groups on the incidence and mortality of CRC is lacking. We aim to investigate disparities in CRC by reviewing a large national cancer registry. METHODS: This is a retrospective cross-sectional study of the Surveillance, Epidemiology and End Results Registry (SEER) of individuals aged 45–79 years from 2000 to 2017. Race was classified as White, Black, American Indian/Alaska Native, and Asian or Pacific Islander. Annual percent change (APC) and incidence risk ratios (IRR) were calculated for sex and race. Kaplan-Meier estimations and log-rank tests were used to evaluate cancer-specific survival outcomes. Statistical significance was set at P < 0.05. RESULTS: Among 690,450 patients, there were 512,285 patients age 45–79 years diagnosed with CRC from 2000 to 2017. A higher proportion of patients had distal tumors versus proximal tumors (62% vs 38%, P < 0.001). SEER summary staging showed that most tumors were localized (40%) compared to regional (35%), distant cancer (20%), and unknown (4%). Approximately 23% of tumors on presentation occurred in the rectum (n = 114,873), followed by 21% in the sigmoid (102,850), 14% in the cecum (70,084), 12% in the ascending colon (n = 60,227), and 29.5% other locations. During the study period, the incidence of CRC decreased for both males and females, respectively (APC −2.14 vs −1.81). Amongst all racial groups, African American showed the least decline in incidence of CRC. African American females showed the highest risk for CRC (IRR 1.34; 95% CI 1.32–1.36, P < 0.001) compared to other females or males from different racial groups [Figure 1]. Subgroup analysis using Kaplan Meier estimations showed that African American females had the poorest 5-year survival rate (56%) compared to White females (66%), American Indian/Alaska Native females (58%), and Asian or Pacific Islander females (66%). Among males, American Indian/Alaska Natives had the poorest 5-year survival (54%) compared to African American males (61%), White males (66%), and Asian or Pacific Islander males (66%). CONCLUSION: Overall, the incidence of colorectal cancer is declining. However, the incidence of CRC remains highest in African Americans females who are also burden with poor survival rates.Figure 1.: Forest plot for Incidence Rate Ratios (IRR) for colorectal cancer (CRC) based on gender and race/ethnicity.Table 1.: One through 5-year survival rates based on gender and race/ethnicity.