Racial–Ethnic Disparities in Late-Stage Colorectal Cancer Among Hispanics and Non-Hispanic Whites of New Mexico

Background.Previous analyses indicated that New Mexican Hispanics and American Indians (AI) did not experience the declining colorectal cancer (CRC) incidence and mortality rates observed among non-Hispanic whites (NHW). We evaluated more recent data to determine whether racial/ethnic differences persisted.Methods.We used New Mexico Surveillance Epidemiology and End Results data from 1995 to 2009 to calculate age-specific incidence rates and age-adjusted incidence rates overall and by tumor stage. We calculated mortality rates using National Center for Health Statistics’ data. We used joinpoint regression to determine annual percentage change (APC) in age-adjusted incidence rates. Analyses were stratified by race/ethnicity and gender.Results.Incidence rates continued declining in NHW (APC −1.45% men, −1.06% women), while nonsignificantly increasing for AI (1.67% men, 1.26% women) and Hispanic women (0.24%). The APC initially increased in Hispanic men through 2001 (3.33%,P=0.06), before declining (−3.10%,P=0.003). Incidence rates declined in NHW and Hispanics aged 75 and older. Incidence rates for distant-stage cancer remained stable for all groups. Mortality rates declined significantly in NHW and Hispanics.Conclusions.Racial/ethnic disparities in CRC persist in New Mexico. Incidence differences could be related to risk factors or access to screening; mortality differences could be due to patterns of care for screening or treatment.

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Spatial association of racial/ethnic disparities between late-stage diagnosis and mortality for female breast cancer: where to intervene?

International Journal of Health Geographics ◽

10.1186/1476-072x-10-24 ◽

2011 ◽

Vol 10 (1) ◽

pp. 24 ◽

Cited By ~ 21

Author(s):

Nancy Tian ◽

J Gaines Wilson ◽

F Benjamin Zhan

Keyword(s):

Breast Cancer ◽

Late Stage ◽

Spatial Association ◽

Ethnic Disparities ◽

Female Breast Cancer ◽

Female Breast ◽

Late Stage Diagnosis ◽

Racial Ethnic

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Racial/ethnic disparities in early‐onset colorectal cancer: implications for a racial/ethnic‐specific screening strategy

Cancer Medicine ◽

10.1002/cam4.3811 ◽

2021 ◽

Author(s):

Ana R. Acuna‐Villaorduna ◽

Juan Lin ◽

Mimi Kim ◽

Sanjay Goel

Keyword(s):

Colorectal Cancer ◽

Early Onset ◽

Ethnic Disparities ◽

Screening Strategy ◽

Racial Ethnic ◽

Early Onset Colorectal Cancer

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Racial ethnic disparities in clinical/pathological features, treatment, and survival among patients with early-onset colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.21 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 21-21

Author(s):

Michael Lyudmer ◽

Riya Jayesh Patel ◽

Adel Chergui ◽

Seda Serra Tolu ◽

Devika Rao ◽

...

Keyword(s):

Colorectal Cancer ◽

Survival Data ◽

Early Onset ◽

Ethnic Disparities ◽

Pathological Features ◽

Biologic Treatment ◽

Kras Mutations ◽

Exact Test ◽

Racial Ethnic ◽

Early Onset Colorectal Cancer

21 Background: Globally, the incidence of early-onset colorectal cancer has risen. Racial disparities in colorectal cancer (CRC) are well-described, however data in EO by race/ethnicity is lacking. We aim to compare the presenting features, treatment, and survival features of patients with metastatic early-onset CRC (EO). Methods: Patients with metastatic CRC diagnosed between 2010-2019 at two NYC hospitals were identified by tumor registry (n = 646). Clinical/pathological features, treatment and survival data was collected by chart review and compared between Non-Hispanic Whites (NHW), Non-Hispanic Blacks (NHB) and Hispanics (H) using Chi-square or Fisher’s exact test. Kaplan Meier curves were plotted to compare overall survival (OS) among groups. Stata v15 was used for statistical analysis. Results: Of 646 CRC patients, 126 (21.5%) were NHW, NHB or H diagnosed with EO with a frequency ranging from 16.6% in NHW to 26.1% in H. Non statistically significant lower frequencies of male gender, low/moderate grade, left-sided tumors,and higher frequency of KRAS mutations were seen in NHB (Table). Metastectomy was performed in 20 patients (13.9%) and did not differ between groups. There was no difference in the use of chemotherapy or biologics in general (Table), but NHW were more likely to get cetuximab than NHB (OR:4.5, p = 0.02) and H (OR:4.7, p = 0.02).There were no differences in median OS (1.8 vs. 2.2 vs. 2 years, p = 0.9)or 1-year OS (72% vs 72.3% vs 70.8%) in NHW, NHB and H, respectively. A lower 5-year OS was seen in NBH (14.5%) and Hispanics (24.4%) compared to NHW (44%). Conclusions: EO-CRC is more frequently seen in minority racial/ethnic groups. Despite no differences in the use of chemotherapy or biologic treatment in general, NHB have a lower 5-year survival rate compared to NHW and H. [Table: see text]

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Distance-to-care: Stage at diagnosis for New Mexico (NM) residents with colorectal cancer (CRC).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.4_suppl.421 ◽

2012 ◽

Vol 30 (4_suppl) ◽

pp. 421-421 ◽

Cited By ~ 1

Author(s):

Meredith C. Mason ◽

Andrew Bruner ◽

Angela W. Meisner ◽

Katherine T. Morris ◽

Itzhak Nir ◽

...

Keyword(s):

Colorectal Cancer ◽

Logistic Regression ◽

New Mexico ◽

Late Stage ◽

Early Stage ◽

Stage At Diagnosis ◽

Multiple Logistic Regression ◽

Place Of Residence ◽

Distance To Care ◽

Incident Cases

421 Background: CRC is a leading cause of morbidity and mortality among NM’s American Indians, Hispanics, and non-Hispanic whites. Previous studies have shown that rural residents are more likely than urban dwellers to be diagnosed with late stage disease. Geographically New Mexico is the 5th largest state with a population of 2 million, many of whom reside in rural regions. This study was designed to characterize the association between distance-to-care and stage of disease at diagnosis in NM. Methods: The population-based NM Tumor Registry was used to identify records for all incident cases of CRC between 2001-2008. Latitude and longitude were determined for the place of residence for cancer cases and for the facility where each case was diagnosed. The “Great Circles” algorithm was used to estimate the distance from place of residence to the diagnosing facility. The percentage of cases diagnosed with early stage vs. other stages (i.e., regional, distant, and unknown stages-combined) was assessed by quartile of distance-to-care with the use of the chi-squared test for trend. Multiple logistic regression was used to characterize the association between stage and quartile of distance-to-care while controlling for other factors know to be associated with stage at diagnosis. Results: Analysis was based on 6,291 incident cases of CRC that were diagnosed among NM residents. Latitude and longitude for both place of residence at diagnosis and location of diagnosing facility were available for 4,385 (69.7%) of all incident cases. The percentage of cases diagnosed at early stage was inversely related to the distance between the place of residence at diagnosis and the facility where the cancer was diagnosed, as follows: 41.4% of cases in Quartile 1 (shortest distance-to-care); 39.9% in Quartile 2; 37.8% in Quartile 3; and 35.3% in Quartile 4 (p=0.002).By multiple logistic regression, distance-to-care was a significant predictor of stage at diagnosis after adjustment of sex, age and race/ethnicity. Conclusions: Rural residents of NM who must travel relatively long distances to receive medical care are at increased risk of being diagnosed at late stage colorectal cancer.

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