Highlights
- •Black patients have worse 5-year overall survival when compared to white patients in stage IV colorectal cancer.
- •Patients who have chemotherapy for stage IV CRC have significantly better survival than in patients who do not get chemotherapy.
- •Colon cancer had significantly worse survival than rectal cancer. Black patients had significantly higher comparative rate of colon cancer.
Abstract
Background
The aims of this study were to determine the impact of race and socioeconomics on
survival in patients with stage IV colorectal cancer.
Methods
A prospective database of stage IV colorectal cancer patients treated at a multi-hospital
health system from 2015 to 2019 was retrospectively analyzed. Univariate and multivariate
survival analysis using log-rank Mantel-Cox test and Cox proportional hazard model
were performed to determine the impact of race, socioeconomic factors, presentation,
and treatment on overall survival.
Results
4012 patients were diagnosed with colorectal cancer, of which 803 patients were stage
IV. There were 677 (84.3%) White, and 108 (13.4%) Black patients. Black patients have
worse 5-year overall survival than white patients (HR 1.43 (1.09–1.87)). Patients
who received chemotherapy had significantly better survival than patients who did
not receive chemotherapy (HR 0.58 (0.47–0.71)). Black patients have significantly
lower rates of receiving chemotherapy as compared to white patients (61.1% vs 75.37%,
p = 0.0018).
Conclusion
Patients with Stage IV colorectal cancer have worse survival if they are black, older
age, and did not receive chemotherapy.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Surveillance, Epidemiology, and End Results Program. Cancer Stat Facts: Colorectal Cancer.2021 ([Online]. Available:)https://seer.cancer.gov/statfacts/html/colorect.htmlDate accessed: January 31, 2022
- Cancer survival in five continents: a worldwide population-based study (CONCORD).Lancet Oncol. 2008; 9: 730-756
- Colon cancer survival in the United States by race and stage (2001-2009): findings from the CONCORD-2 study.Cancer. 2017; 24: 5014-5036
- Association of insurance with cancer care utilization and outcomes.CA A Cancer J Clin. 2008; 58: 9-31
- Diverging racial and ethnic disparities in access to physician care: comparing 2000 and 2007.Med Care. 2012; 50: 327-334
- Colorectal cancer in african Americans.Am J Gastroenterol. 2005; 100: 515-523
- Survival Rates for Colorectal Cancer.2021 ([Online]. Available:)https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.htmlDate accessed: January 31, 2022
- Geographic residency status and census tract socioeconomic status as determinants of colorectal cancer outcomes.Am J Publ Health. 2014; 104: 63-71
- Association of Race/Ethnicity with overall survival among patients with colorectal liver metastasis.JAMA Netw Open. 2020; 3e2016019
- Differences in survival between colon and rectal cancer from SEER data.PLoS One. 2013; 8e78709
- A comparison of colon and rectal somatic DNA alterations.Disease of colon and rectum. 2009; 52: 1304-1311
- Racial/Ethnic disparities in survival among patients with young-onset colorectal cancer.J Clin Oncol. 2016; 34: 2148-2156
- Influence of race on microsatellite instability and CD8+ T cell infiltration in colon cancer.PLoS One. 2014; 9e100461
B. Sylvester, D. Huo, A. Khramtsov, et al, “Molecular Analysis of Colorectal Tumors within a Diverse Patient Cohort at a Single.
Article info
Publication history
Published online: December 23, 2022
Accepted:
December 17,
2022
Received in revised form:
December 1,
2022
Received:
August 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
