P0421 - Impact of Racial Disparities and Socioeconomic Factors on Tumor Stage at Diagnosis in Early-Onset Colorectal Cancer: A SEER Database Study

Award: Presidential Poster Award

Rohit Goyal, MD¹, Karan Sachdeva, MD², Lovekirat Dhaliwal, MD³, Rishi Chowdhary, MD⁴, Maryam Mubashir, MD², Aditya Vyas, MD⁵, Gabrielle Sanford, MD⁵, Michael Tran, MD⁵, Anjul Verma, MD⁶, Shazia Rashid, MD², Sudha Pandit, MD^2
1Ochsner LSU Health, Shreveport, LA; ²LSU Health, Shreveport, LA; ³Emory University School of Medicine, Atlanta, GA; ⁴Metrohealth Medical Center, Cleveland, OH; ⁵Louisiana State University Health, Shreveport, LA; ⁶Texas Tech University Health Sciences Center, Odessa, TX

Introduction: Colorectal cancer (CRC) remains the second leading cause of cancer-related mortality in the USA, attributing to up to 9 % of cancer-related deaths. Although vigorous screening has resulted in a decrease in the overall incidence of CRC, the incidence of early-onset CRC (EOCRC) (diagnosed before the age of 50 years) is on the rise. Racial disparities in the incidence of EOCRC have been reported in the past. We examined the impact of race and socioeconomic factors on the tumor stage at diagnosis in EOCRC.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) 17 database, we identified patients aged 20-49 years who were diagnosed with malignant cancer of the colon and rectum (excluding the appendix) with histology limited to adenocarcinoma from 2000 and 2020. Age-adjusted incidence rate (IR) and incidence rate ratio (IRR) were calculated for different stages at diagnosis (per the combined summary stage 2004+, classifying CRC into localized, regional, and distant) and analyzed across race/ethnicity (White, Black, Asian/Pacific Islander [API], American Indian/Alaskan Native [AI/AN], and Hispanic), sex, median household income, and county (metropolitan, non-metropolitan). Patients with un-staged or missing data were excluded from the analysis.

Results: We included 41,230 cases of EOCRC. Significant differences in the IRR were observed across race/ethnicity and other socioeconomic variables at each tumor stage at diagnosis as depicted in Image 1. For all three tumor stages at diagnosis, IRR trended down significantly with increasing median household income and was significantly higher in non-metropolitan counties. When compared to white patients, Black patients had significantly higher IRR for all three stages, AI/AN patients for localized and distant cancer, and API patients for localized cancer. Hispanic patients had a significantly lower IRR in comparison to white patients for all three stages. Additionally, on comparing the proportion of patients in individual races for the incident stage of diagnosis, we observed that Black, AI/AN, and Hispanic patients had a higher proportion of being diagnosed with distant CRC compared to White patients.

Discussion: Black and AI/AN patients not only have a higher incidence of EOCRC, but they also have higher chances of being diagnosed at later stages. Promoting awareness of early screening for CRC and easing the accessibility to healthcare among high-risk groups can help mitigate these disparities.



Disclosures:


Rohit Goyal, MD¹, Karan Sachdeva, MD², Lovekirat Dhaliwal, MD³, Rishi Chowdhary, MD⁴, Maryam Mubashir, MD², Aditya Vyas, MD⁵, Gabrielle Sanford, MD⁵, Michael Tran, MD⁵, Anjul Verma, MD⁶, Shazia Rashid, MD², Sudha Pandit, MD². P0421 - Impact of Racial Disparities and Socioeconomic Factors on Tumor Stage at Diagnosis in Early-Onset Colorectal Cancer: A SEER Database Study, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.