TY - JOUR
T1 - Racial Differences in Stage IV Colorectal Cancer Survival in Younger and Older Patients
AU - Wallace, Kristin
AU - DeToma, Allan
AU - Lewin, David N.
AU - Sun, Shaoli
AU - Rockey, Don
AU - Britten, Carolyn D.
AU - Wu, Jennifer D.
AU - Ba, Aissatou
AU - Alberg, Anthony J.
AU - Hill, Elizabeth G.
N1 - Funding Information:
This work was supported by the National Cancer Institute (NCI) by way of the Hollings Cancer Center NCI Cancer Center Support Grant (grant P30 CA138313) and a K07 Career Development Award to K.W. (grant K07CA151864-01A1).
Publisher Copyright:
© 2016 Elsevier Inc.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/9
Y1 - 2017/9
N2 - African Americans (AAs) compared to European Americans (EAs) have poorer stage specific survival from colorectal cancer (CRC), especially among younger patients. We used population-based Surveillance, Epidemiology, and End Results (SEER) registry data to evaluate the impact of race, age on advanced stage CRC survival. We found that younger AAs (vs. EAs) had a significantly higher risk of death which was attenuated in older patients. Introduction African Americans (AAs) compared with European Americans (EAs) have poorer stage-specific survival from colorectal cancer (CRC). Recent reports have indicated that the racial difference in survival has worsened over time, especially among younger patients. To better characterize this association, we used population-based Surveillance, Epidemiology, and End Results registry data to evaluate the effect of race on stage IV CRC survival in patients aged < 50 and ≥ 50 years. Patients and Methods The population included 16,782 patients diagnosed with stage IV colon and rectal adenocarcinoma from January 1, 2004 and December 31, 2011. Cox proportional hazards regression was used to evaluate the association between race and other prognostic factors and the risk of death in each age group. Results Younger AAs compared with EAs had a greater prevalence of proximal CRC at diagnosis, a factor associated with a significantly greater risk of death in both races. Among patients < 50 years old, AAs had a greater risk of death compared with EAs (hazard ratio, 1.35; 95% confidence interval, 1.20-1.51), which was attenuated in patients ≥ 50 years of age (hazard ratio, 1.10; 95% confidence interval, 1.04-1.16); P for interaction = .01. Conclusion The results revealed poor overall survival for AAs compared with EAs, especially for those < 50 years of age. The greater prevalence of proximal CRC at diagnosis among younger AAs (vs. EAs) might contribute to the racial difference in survival. Future studies are needed to understand how the colonic location affects the efficacy of treatment regimens.
AB - African Americans (AAs) compared to European Americans (EAs) have poorer stage specific survival from colorectal cancer (CRC), especially among younger patients. We used population-based Surveillance, Epidemiology, and End Results (SEER) registry data to evaluate the impact of race, age on advanced stage CRC survival. We found that younger AAs (vs. EAs) had a significantly higher risk of death which was attenuated in older patients. Introduction African Americans (AAs) compared with European Americans (EAs) have poorer stage-specific survival from colorectal cancer (CRC). Recent reports have indicated that the racial difference in survival has worsened over time, especially among younger patients. To better characterize this association, we used population-based Surveillance, Epidemiology, and End Results registry data to evaluate the effect of race on stage IV CRC survival in patients aged < 50 and ≥ 50 years. Patients and Methods The population included 16,782 patients diagnosed with stage IV colon and rectal adenocarcinoma from January 1, 2004 and December 31, 2011. Cox proportional hazards regression was used to evaluate the association between race and other prognostic factors and the risk of death in each age group. Results Younger AAs compared with EAs had a greater prevalence of proximal CRC at diagnosis, a factor associated with a significantly greater risk of death in both races. Among patients < 50 years old, AAs had a greater risk of death compared with EAs (hazard ratio, 1.35; 95% confidence interval, 1.20-1.51), which was attenuated in patients ≥ 50 years of age (hazard ratio, 1.10; 95% confidence interval, 1.04-1.16); P for interaction = .01. Conclusion The results revealed poor overall survival for AAs compared with EAs, especially for those < 50 years of age. The greater prevalence of proximal CRC at diagnosis among younger AAs (vs. EAs) might contribute to the racial difference in survival. Future studies are needed to understand how the colonic location affects the efficacy of treatment regimens.
KW - Colon cancer
KW - Early onset
KW - Metastatic
KW - Race
KW - Survival
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U2 - 10.1016/j.clcc.2016.11.006
DO - 10.1016/j.clcc.2016.11.006
M3 - Article
C2 - 28065664
AN - SCOPUS:85008481729
VL - 16
SP - 178
EP - 186
JO - Clinical Colorectal Cancer
JF - Clinical Colorectal Cancer
SN - 1533-0028
IS - 3
ER -
