P1921 - Racial and Sociodemographic Disparities Affecting Hospitalization Outcomes of Anal Cancer: Insights From National Inpatient Database

Manasa Ginjupalli, MBBS, MD¹, Jayalekshmi Jayakumar, MBBS, MD², Anuj R. Sharma, MBBS³, Vikash Kumar, MD⁴, Iyad Al-bustami, MD, MPH(c)⁵, Khalid Aloum, MD⁶, Hima Varsha. Voruganti, MBBS, MD⁷, Wendy T. Garzon-Siatoya, MD⁶, Camelia Ciobanu, MD³, Praneeth Bandaru, MBBS, MD^3
1The Brooklyn Hospital Center, New York, NY; ²The Brooklyn Hospital Center, Brooklyn, NY; ³Brooklyn Hospital Center, Brooklyn, NY; ⁴Creighton University School of Medicine, Brooklyn, NY; ⁵Brooklyn Hospital Center, Houston, TX; ⁶St. Barnabas Hospital, Bronx, NY; ⁷North Alabama Medical Center, Florence, AL

Introduction: Anal cancer(AC) is a malignant neoplasm of the tissue in the anal canal, most commonly associated with Human Papilloma Virus(HPV) infection. It is one of the less common gastrointestinal cancers, however its incidence has been on the rise since 2000, with rapid increase in incidence rates in African Americans and adults above 50 years. While racial disparities in the incidence rates of AC were studied, the impact of race and sociodemographics on outcomes specific to the inpatient population is unexplored, which we tried to analyze in this study.

Methods: A cross-sectional analysis of the National Inpatient Sample Database 2016 -2020 was done to find AC hospitalizations using ICD 10 codes. This cohort was stratified by race to whites, blacks, hispanics & others. Various patient and hospitalization characteristics including type of admission, disposition, resource utilization were studied. Multivariate regression was used to analyze the impact of race on in-hospital outcomes and resource utilization of AC after adjusting for location, patient & hospital characteristics and Charlson comorbidity index.

Results: We identified 68,174 hospitalizations for AC, of which majority of patients were Whites [Table 1]. Mean age of AC hospitalizations was 62.7 years of which 60.4% were females. Irrespective of race, majority admissions were non-elective to urban teaching hospitals with large bed-size and had a length of stay over seven days. Majority of discharges were routine (50.32% whites, 52.85% blacks, 58.18% hispanics) followed by facility/home with home care (46.99% whites, 42.97% blacks, 40% hispanics). Mortality was 2.69% in whites, 4.18% in blacks and 1.82% in hispanics. Multivariate analysis showed a statistically significant increase in length of stay and mortality among Blacks compared to Whites. Resource utilization did not differ significantly between most racial groups and Whites [Table 1].

Discussion: Our findings highlight significant disparities in hospitalization outcomes among different racial groups, particularly affecting African Americans with AC. These disparities may stem from cultural shifts introducing risk factors such as HPV infection, immunosuppression from HIV or organ transplants, and changes in sexual behaviors. Implementing targeted treatments and tailored social support services for diverse racial demographics could potentially improve in-hospital outcomes, but further investigation is required to confirm causality.


Disclosures:


Manasa Ginjupalli, MBBS, MD¹, Jayalekshmi Jayakumar, MBBS, MD², Anuj R. Sharma, MBBS³, Vikash Kumar, MD⁴, Iyad Al-bustami, MD, MPH(c)⁵, Khalid Aloum, MD⁶, Hima Varsha. Voruganti, MBBS, MD⁷, Wendy T. Garzon-Siatoya, MD⁶, Camelia Ciobanu, MD³, Praneeth Bandaru, MBBS, MD³. P1921 - Racial and Sociodemographic Disparities Affecting Hospitalization Outcomes of Anal Cancer: Insights From National Inpatient Database, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.