Racial disparities in colorectal cancer clinicopathological and molecular tumor characteristics: a systematic review

Lawler, Thomas; Parlato, Lisa; Warren Andersen, Shaneda

doi:10.1007/s10552-023-01783-y

Cited by 3 publications

(1 citation statement)

References 147 publications

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“…Moreover, a higher prevalence of KRAS mutations has been observed in NH-Black patients with rectal cancer compared to NH-White patients ( 25 - 27 ). Despite this, the majority of NH-Black patients were not referred for KRAS mutation counseling and/or testing ( 28 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Recent racial/ethnic disparities in cancer-specific mortality among patients diagnosed with rectal cancer

Li,

Xu,

Chen

et al. 2024

Transl Gastroenterol Hepatol

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Background African American patients frequently receive nonstandard treatment and demonstrate poorer overall survival (OS) outcomes compared to White patients. Our objective was to analysis whether racial/ethnic disparities in rectal cancer-specific mortality remain after accounting for clinical characteristics, treatment, and access-to-care-related factors. Methods Individuals diagnosed with rectal cancer between 2011 and 2020 were identified using the Surveillance, Epidemiology, and End Results Database. The cumulative incidence of rectal cancer-specific mortality was computed. Sub-distribution hazard ratios (sdHRs) and 95% confidence intervals (CIs) for rectal cancer-specific mortality associated with race/ethnicity were estimated using Fine and Gray model with stepwise adjustments for clinical characteristics, treatment modalities, and factors related to access-to-care. Results Among 54,370 patients, non-Hispanic (NH) Black individuals exhibited the highest cumulative incidence of rectal cancer-specific mortality (39%), followed by American Indian/Alaska Native (AI/AN) (35%), Hispanics (32%), NH-White (31%), and Asian/Pacific Islander (API) (30%). After adjusting for clinical characteristics, NH-Black patients had a 28% increased risk of rectal cancer mortality (sdHR, 1.28; 95% CI: 1.20–1.35) compared to NH-White patients. In contrast, mortality disparities between Hispanic-White, AI/AN-White, and API-White groups were not significant. The Black-White mortality differences persisted even after adjustments for treatment and access-to-care-related factors. In stratified analyses, among patients with a median household income below $59,999, AI/AN patients showed higher mortality than NH-Whites when adjusted for clinical characteristics (sdHR, 1.32; 95% CI: 1.03–1.70). Conclusions Overall, the racial/ethnic disparities in rectal cancer-specific mortality were largely attributable to differences in clinical characteristics, treatment modalities, and factors related to access-to-care. These findings emphasize the critical need for equitable healthcare to effectively address and reduce the significant racial/ethnic disparities in rectal cancer outcomes.

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