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Immigrant Health and Early-Onset Colorectal Cancer Disparities: Results From the Spanish Early-Onset Colorectal Cancer Consortium

2024; Lippincott Williams & Wilkins; Issue: 10 Linguagem: Inglês

10.1200/go-24-00393

2687-8941

José Perea, Marc Martí, Ariadna García-Rodríguez, R. Vidal Tocino, José A. Sánchez Alcázar, Irene López Rojo, Sara Encinas García, Elena Hurtado, Luís Miguel Jiménez, Edurne Álvaro, Ana Burdaspal, Gonzalo Sanz, Rodrigo Sanz López, Marta Jiménez Toscano, Mar Iglesias Comas, Fernando Jiménez Escovar, Adriana Cavero, Francesc Balaguer, María Daca-Álvarez, Araceli Ballestero, Javier Díe Trill, Sirio Melone, J.A. Esper Rueda, Sergio Hernández‐Villafranca, Damián García‐Olmo, Carlos Pastor Idoate, A. Perez, Lorena Brandáriz, Cristina Viyuela, Alfredo Vivas López, Paula Muñoz, Rogelio González‐Sarmiento, Andreana N. Holowatyj, Edgardo Celi Altamarina, Elena García García, M. Pardo, L. Heras Lopez, Manuel Escanciano, Vicente Portugal, María Arriba Domenech, I Gomez, Jaime Zorrilla, María Daca-Álvarez, Teresa Ocaña, Joaquín Castillo, Míriam Cuatrecasas, Sabela Carballal, Hardeep Kumari, Leticia Moreira, Lorena Moreno, María Pellisé, Ariadna Sánchez, Ana Ramı́rez de Molina, Gonzalo Colmenarejo, Isabel Espinosa‐Salinas, Lara P. Fernández, Marta Gómez de Cedrón, Luís A. Corchete, Juan Luis Garcı́a, Paula García-Vallés, Ana B. Herrero, J. López Pérez, María Luisa de Fuenmayor, O. Alonso, Sara Encinas, Ana Teijo, Jorge Arredondo, Ignacio Matos, Javier Rodríguez, A Candela, José María Fernández Cebrián, Juan Ocaña Jiménez, Jana Dziaková, Sandra Marín-Cañas, María Suárez Solís, Francisco Blanco‐Antona, Núria Malats, Lidia Estudillo, Miquel Kraft, Franco Marinello, I Salar Valverde,

Multiple and Secondary Primary Cancers

PURPOSE To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin. PATIENTS AND METHODS We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison. RESULTS Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%; P = .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%; P < .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1 v 42.5), more frequently male (77.8 v 47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [ P = .01]), and had a worse prognosis regarding recurrence rates (29.4% v 6.3%). CONCLUSION Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.