P3864 - Unraveling Regional Disparities in Early-Onset Colorectal Cancer Mortality Across the United States Between 2000 - 2022

Yazan Abboud, MD¹, Ahmed Al-Khazraji, MD¹, Paul Gaglio, MD², Kaveh Hajifathalian, MD^1
1Rutgers New Jersey Medical School, Newark, NJ; ²Rutgers NJ Medical School, Newark, NJ

Introduction: Early-onset colorectal cancer (EO-CRC) stands as a significant contributor to cancer-related deaths globally. Previous studies have highlighted rising incidence of EO-CRC in the US, particularly notable in Western regions. However, there is a notable gap in the literature on the variations of recent EO-CRC mortality across different US regions. Therefore, we aimed to evaluate national mortality from EO-CRC across different geographical regions in the US using a comprehensive database.

Methods: Mortality rates of EO-CRC between 2000-2022 were age-adjusted to the standard 2000 US population and calculated from the CDC’s National Center of Health Statistics database which covers ~100% of the US population using SEER*Stat software. Mortality rates were categorized by US geographical region into West, Midwest, Northeast, and South. Time-trends were estimated as annual percentage change (APC) and average APC (AAPC) using Joinpoint Regression and the weighted Bayesian Information Criteria which are statistical methods used to generate best-fit trends (P-value cutoff 0.05).

Results: There were 147,024 patients (56.6% males) whose death was attributed to EO-CRC in the US between 2000-2022. Overall mortality rates of EO-CRC were initially decreasing between 2000-2005 (APC=-1.56, P=0.03) and increased afterward between 2005-2022 (APC=0.87, P< 0.001). When categorized by geographical region, EO-CRC mortality rates and time-trends varied. In the West (29,872 deaths), mortality mirrored the overall population and was initially decreasing followed by a steady increase between 2005-2022 (APC=1.32, P=0.02). The Midwest (31,121 deaths) also had similar findings with steadily increasing mortality between 2005-2022 (APC=1.28, P=0.003). The northeast (24,537 deaths) had an overall stable trend (AAPC=0.02, P=0.97). Lastly, the south also mirrored the overall population with steadily increasing mortality between 2004-2022 (APC=0.48, P=0.003).

Discussion: Evaluation of nearly all deaths attributed to EO-CRC in the US shows that EO-CRC mortality rates have been steadily increasing over the last 18 years across all geographical regions except the northeast. We show that the most pronounced increase in mortality was in the West, which also experienced the greatest increase in incidence as per previous studies. These findings provide insight into the national burden of EO-CRC, advocating for further resource allocation, and suggesting an impending need for more investigations to improve outcomes in younger patients.



Disclosures:


Yazan Abboud, MD¹, Ahmed Al-Khazraji, MD¹, Paul Gaglio, MD², Kaveh Hajifathalian, MD¹. P3864 - Unraveling Regional Disparities in Early-Onset Colorectal Cancer Mortality Across the United States Between 2000 - 2022, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.