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

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Clinical Oncology Department, Faculty of Medicine, Ain Shams University, Lofty Elsayed Street, Cairo, 11566, Egypt

    Muneer J. Al-Husseini, Anas M. Saad & Ahmad Rachid

  2. Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, USA

    Khalid A. Jazieh

  3. Faculty of Medicine, Al-Azhar University, Cairo, Egypt

    Abdelmagid M. Elmatboly

  4. Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA

    Mohamed M. Gad

  5. Pathology Department, Faculty of Medicine, Damascus University, Cairo, Egypt

    Inas A. Ruhban

  6. Division of Hematology/Oncology, Mayo Clinic Cancer Center, 5881 E. Mayo Blvd, Phoenix, AZ, 85054, USA

    Talal Hilal

Authors
  1. Muneer J. Al-Husseini
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  2. Anas M. Saad
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  3. Khalid A. Jazieh
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  4. Abdelmagid M. Elmatboly
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  5. Ahmad Rachid
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  6. Mohamed M. Gad
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  8. Talal Hilal
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Correspondence to Anas M. Saad or Talal Hilal.

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Al-Husseini, M.J., Saad, A.M., Jazieh, K.A. et al. Outcome disparities in colorectal cancer: a SEER-based comparative analysis of racial subgroups. Int J Colorectal Dis 34, 285–292 (2019). https://doi.org/10.1007/s00384-018-3195-3

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  • DOI: https://doi.org/10.1007/s00384-018-3195-3

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