Study of SEER Data Identifies Racial/Ethnic Disparities in Survival in Patients With Young-Onset Colorectal Cancer


Key Points

  • Overall survival at 5 years after diagnosis was 68.1%, 54.9%, and 62.9% among white, black, and Hispanic patients.
  • Adjusted risk of cancer-specific mortality was higher for black vs white patients for both colon cancer and rectum/rectosigmoid junction cancer.

In a study of Surveillance, Epidemiology, and End Results (SEER) data reported in the Journal of Clinical Oncology, Holowatyj et al found that survival was significantly poorer in black vs white patients diagnosed with colorectal cancer between the ages of 20 and 49 years.

Study Details

The study involved data on 28,145 patients diagnosed between 2000 and 2009, including 19,497 white, 4,384 black, and 4,264 Hispanic patients. Overall survival at 5 years after colorectal cancer diagnosis was 68.1% among white patients, 54.9% among black patients, and 62.9% among Hispanic patients (P < .001 overall).

Cancer-Specific Mortality

In analysis adjusting for age, sex, race, disease stage, county-level poverty, and treatment history, risk of cancer-specific death was increased in blacks vs whites for colon cancer (hazard ratio [HR] = 1.35, P < .001) and rectum/rectosigmoid junction cancer (HR = 1.51, P < .001). No significant differences in cancer-specific mortality were observed for white vs Hispanic patients. The largest disparities in cancer-specific mortality for black vs white patients were for those diagnosed with stage II colon cancer (HR = 1.69, 95% confidence [CI] = 1.33–2.14) and those diagnosed with stage III rectal cancer (HR = 1.98, 95% CI = 1.63–2.40).

The investigators concluded, “Survival after [colorectal cancer] diagnosis at a young age is significantly worse among [non-Hispanic blacks] compared with [non-Hispanic whites], even among patients with early-stage disease. Further study is needed to determine whether differences in tumor biology and/or treatment are associated with racial disparities in outcomes, which would have implications for [colorectal cancer] treatment and prevention.”

The study was supported by funding from Wayne State University School of Medicine, the National Institutes of Health, and the National Cancer Institute.

Elena M. Stoffel, MD, MPH, of the University of Michigan Health System, Ann Arbor, is the corresponding author for the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.