P1960 - Elevated Rate of Colorectal Cancer in Native American and Native Alaskans in Alaska Compared to in Other Regions: An Analysis From 2016 to 2020

Tulika Saggar, MD¹, Atul Sinha, MD¹, James R. Pellegrini, MD², Paul Mustacchia, MD, MBA^1
1Nassau University Medical Center, East Meadow, NY; ²Nassau University Medical Center, Great River, NY

Introduction: Colorectal cancer is one of the leading causes of cancer in the United States and there are estimated to be over 150,000 new cases in 2024. Although the rate of new cases of colorectal cancer has decreased over the past few decades, some populations are experiencing increased incidence rates. Native American and Alaskan Native (NA/AN) populations are known to have higher rates of colorectal cancer when compared to whites. In this study we examined the regional and gender related rates in recent new cases of colorectal cancer.

Methods: A retrospective cohort study was performed on 28,609 patients from 2016 to 2020 using the CDC and NCI 2022 submission data from years 1999-2020. Analysis of NA/AN patients was restricted to areas where healthcare services were provided by the Indian Health Service (IHS). Analysis of white patients was restricted to those who lived in IHS Purchased/Referred Care Delivery Areas, which consisted of counties containing NA/AN reservations. Rates were age-adjusted to the US standard population in 2000.

Results: The overall rate of colorectal cancer in the United States was 35.1 per 100,000 in whites and 50.1 per 100,000 in NA/AN, a 1.42 times higher rate in NA/AN. The highest regional rate difference in NA/AN versus whites was in the Alaska region, where NA/AN had a 2.58 times higher rate of colorectal cancer compared to whites (90.3 vs 35.0). The lowest regional rate difference in NA/AN versus whites was in the Eastern region, where NA/ANs had only a 1.01 times higher rate of colorectal cancer compared to whites (36.0 vs 35.8). The highest gender-related rate difference was seen in the Alaska region, where NA/AN females had a 2.77 times higher rate of colorectal cancer compared to white females (87.2 vs 31.5).

Discussion: Our study has demonstrated that Native American and Alaskan Natives have much higher rates of colorectal cancer compared to whites. This rate is even higher in certain regions, particularly the Alaska region. Although NA/AN females had lower overall rates than NA/AN males, there were certain regions where NA/AN females had higher rates of colorectal cancer compared to NA/AN men. This finding suggests that much more research needs to be done about these regional differences, particularly in Alaska, to determine if any genetic factors or access to care issues exist in these areas. Physicians in these higher risk areas must be aware of these findings and ensure that their patients get colorectal cancer screening appropriately.



Disclosures:


Tulika Saggar, MD¹, Atul Sinha, MD¹, James R. Pellegrini, MD², Paul Mustacchia, MD, MBA¹. P1960 - Elevated Rate of Colorectal Cancer in Native American and Native Alaskans in Alaska Compared to in Other Regions: An Analysis From 2016 to 2020, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.