International Journal of Colorectal Disease

, Volume 34, Issue 2, pp 285–292 | Cite as

Outcome disparities in colorectal cancer: a SEER-based comparative analysis of racial subgroups

  • Muneer J. Al-Husseini
  • Anas M. SaadEmail author
  • Khalid A. Jazieh
  • Abdelmagid M. Elmatboly
  • Ahmad Rachid
  • Mohamed M. Gad
  • Inas A. Ruhban
  • Talal HilalEmail author
Original Article



Previous studies of ethnic disparities in colorectal cancer (CRC) have focused mainly on patients of Caucasian and African-American descent. We aimed to evaluate outcomes for a range of races, representing a broader demographic of the US population.


The Surveillance, Epidemiology, and End Results database was queried to identify patients with CRC diagnosed between 1994 and 2014. We performed unadjusted Kaplan-Meier test and multivariable covariate-adjusted Cox models to calculate the overall and CRC-specific survival of patients according to their race.


We identified 401,723 patients diagnosed with CRC between 1994 and 2014. Overall survival (OS) and CRC-specific survival were compared across different races stratified by age, sex, marital status, disease stage and grade, and undergoing surgery as a treatment. Overall, Asian/Pacific Islanders and Hispanics had improved CRC-specific survival compared to Whites (HR = 0.873, 95%CI 0.853–0.893, P < .001, and HR = 0.958, 95%CI 0.937–0.979, P < .001, respectively). Blacks had the worst CRC-specific survival outcomes when compared to Whites (HR = 1.215, 95%CI 1.192–1.238, P < .001). Racial disparity persisted when looking at two different time periods (1994–2003 and 2004–2014).


Asians/Pacific Islanders have improved outcomes from CRC compared to other races. Multifactorial, including genetic, environmental, and socioeconomic factors appear to influence outcomes and need to be addressed separately in order to reduce racial disparities among patients with CRC.


Colorectal cancer Racial disparities Cancer outcomes SEER 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

384_2018_3195_MOESM1_ESM.docx (12 kb)
ESM 1 (DOCX 11 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Oncology Department, Faculty of MedicineAin Shams UniversityCairoEgypt
  2. 2.Department of Internal MedicineCleveland ClinicClevelandUSA
  3. 3.Faculty of MedicineAl-Azhar UniversityCairoEgypt
  4. 4.Heart and Vascular InstituteCleveland ClinicClevelandUSA
  5. 5.Pathology Department, Faculty of MedicineDamascus UniversityCairoEgypt
  6. 6.Division of Hematology/OncologyMayo Clinic Cancer CenterPhoenixUSA

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