Photo Credit: Mohammed Elamine

Mortality from early-onset colorectal cancer (EOCRC) was higher among California patients who were Hispanic, Native Hawaiian or Other Pacific Islander, non-Hispanic Black, and Southeast Asian compared with non-Hispanic White, according to study findings published online in JAMA Network Open.

“Neighborhood socioeconomic status and insurance status attenuated the differences in EOCRC mortality when factored into the analysis,” researchers wrote.

Researchers used data from the California Cancer Registry to investigate racial and ethnic differences in mortality rates among patients diagnosed with colorectal cancer before age 50 years. The study included 22,834 patients diagnosed with EOCRC between 2000 and 2019. Among them, 53.5% were male, and the median follow-up was 4.2 years.

Some 15.5% of patients were Asian American, 30.2% were Hispanic, 0.6% were Native Hawaiian or Other Pacific Islander, 0.5% were non-Hispanic American Indian or Alaska Native, 7.3% were non-Hispanic Black, and 45.9% were non-Hispanic White.

Racial and ethnic disparities in mortality were evident, researchers reported, particularly for patients who were Native Hawaiian or Other Pacific Islander and non-Hispanic Black. Adjusted hazard ratios for EOCRC mortality were 1.34 for patients who were Native Hawaiian or Other Pacific Islander and 1.18 for patients who were non-Hispanic Black compared with patients who were non-Hispanic White.

The study separated patients who were Asian American into seven subgroups: Chinese, Filipino, Japanese, Korean, South Asian, Southeast Asian, and Other Asian. Although the disaggregation revealed notable heterogeneity, no single group showed increased mortality risk after adjustment for covariates, according to the study.

In a base model adjusted for age, sex, and tumor characteristics, the adjusted hazard ratio for EOCRC mortality in Hispanic patients was 1.15 compared with non-Hispanic White patients. However, researchers reported that when neighborhood socioeconomic status was added to the mix, the increased hazard disappeared.

Along the same lines, a 1.17 adjusted hazard ratio for EOCRC mortality in patients who were Southeast Asian, compared with non-Hispanic White, fell to 1.10 when insurance status was added to the model.

“These findings provide novel and important data underscoring the role of social determinants of health in EOCRC-related mortality,” researchers wrote, “and the need to address barriers to care to ensure greater equity in survival for a cancer that affects individuals whose lives are cut short in their prime.”