Abstract 137P
Background
Overall colorectal carcinoma (CRC) survival rates have increased over the years, but this increase has not been equally divided across all patient groups. In this study, we aim to examine the difference in survival rates among minorities and economically disadvantaged groups. To achieve our aim, we divided patients into groups based on race, marital status, urban or rural, socioeconomic status, and we compared survival rates between different groups.
Methods
This was a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. The patients selected for this study were aged 20 years and older and diagnosed with CRC from 2006 to 2020. Patients with unknown tumor size, grade, metastasis, or surgery record were excluded. Census tract-level socioeconomic status (SES) index was assessed in quintiles (group 1 has the lowest SES status, and group 5 has the highest SES status). The demographic characteristics, tumor characteristics, and survival information were analyzed. The Cox proportional hazards multivariate regression model included the statistically significant survival-associated variables in the univariate analysis.
Results
The mortality rate progressively improved from group 2 (HR: 0.92, P<0.001) to group 3 (HR: 0.89, P<0.001), to group 4 (HR: 0.84, P<0.001), to group 5 (HR: 0.77, P<0.001) in reference to group 1 (lowest SES status). Asian people had the lowest mortality rate (HR: 0.83, P<0.001), while white people had the highest morality rate across all races. Married patients had an increased survival probability.
Conclusions
Overall survival of CRC over the 14 years of analysis increased as SES level improved. Furthermore, married patients had increased survival rates compared to other groups. We also observed statistically significant differences in survival rates between different races. Table: 137P
| Variable | Hazard ratio (95% CI) |
| SES Quintiles | |
| Group 1 (lowest) | Referent |
| Group 2 | 0.92 (0.91, 0.94) ∗ |
| Group 3 | 0.89 (0.88, 0.91) ∗ |
| Group 4 | 0.84 (0.83, 0.85) ∗ |
| Group 5 (highest) | 0.77 (0.76, 0.78) ∗ |
| Sex | |
| Male | Referent |
| Female | 0.87 (0.86, 0.88) ∗ |
| Age group, years | |
| 20 – 29 | Referent |
| 30 – 39 | 0.95 (0.88, 1.03) ∗ |
| 40 – 49 | 1.00 (0.93, 1.08) ∗ |
| 50 | 1.65 (1.54, 1.77) ∗ |
| Race | |
| Whites | Referent |
| Hispanic | 0.84 (0.83,0.85) ∗ |
| African American | 0.95 (0.94, 0.96) ∗ |
| Asian | 0.83 (0.82. 0.85) ∗ |
| Native | 0.92 (0.86, 0.98) ∗ |
| Marital status | |
| Married | Referent |
| Single | 1.19 (1.18, 1.21) ∗ |
| Other | 1.47 (1.45, 1.49) ∗ |
| Home location | |
| All urban | Referent |
| Mostly urban | 0.99 (0.98, 1.01) ∗ |
| Mostly rural | 0.96 (0.95, 0.98) ∗ |
| Rural | 0.99 (0.97, 1.00) ∗ |
∗P<0.001
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.