Racial disparities negatively impact outcomes in early-onset colorectal cancer independent of socioeconomic status.
Racial disparities negatively impact outcomes in early-onset colorectal cancer independent of socioeconomic status.
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DOI：
10.1002/cam4.4276
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发表时间：
2021-11
期刊：
影响因子：
4
通讯作者：
Khorana AA
中科院分区：
文献类型：
--
作者：
Kamath SD;Torrejon N;Wei W;Tullio K;Nair KG;Liska D;Krishnamurthi SS;Khorana AA
50岁以下患者的结直肠癌（CRC）发病率正在上升，原因尚不清楚。我们研究了社会经济因素对早发性CRC患者与晚发性CRC患者结局的影响。从2004年到2015年，国家癌症数据库中的CRC患者被纳入并按年龄（50岁以下或50岁以上）分类。通过卡方检验和考克斯模型评估早发与晚发CRC患者在人口统计学和社会经济学因素、疾病特征和生存结局方面的差异。研究人群包括1，061，204例患者，其中108，058例（10.2%）年龄在50岁以下。50岁以下患者的比例随着时间的推移而增加：2004-2006年为9.4%，2007-2009年为10.1%，2010-2012年为10.5%，2013-2015年为10.7%（p < 0.0001）。早发性CRC患者更可能是黑人（15.1% vs. 11.3%）或西班牙裔（8.6% vs. 4.6%），并出现4期疾病（24.9% vs. 17.0%），所有患者p < 0.0001。与白色患者（67.0个月）、西班牙裔患者（91.6个月）或亚洲患者（104.9个月）相比，黑人患者的中位OS最差（58.3个月），p < 0.0001。在有私人保险的早发CRC患者亚组中，黑人患者的OS比白色患者差，即使在收入和教育水平较高的社区也是如此。早发性CRC继续增加。早发性CRC患者更可能是黑人或西班牙裔，并出现4期癌症。在所有收入亚组中，早发性黑人患者的OS均低于白色患者，即使有私人保险。早发性结直肠癌患者更可能是黑人或西班牙裔，并出现4期癌症。在有私人保险的早发CRC患者亚组中，黑人患者的OS比白色患者差，即使在收入和教育水平较高的社区也是如此。
The incidence of colorectal cancer (CRC) in patients under age 50 is rising for unclear reasons. We examined the effects of socioeconomic factors on outcomes for patients with early‐onset CRC compared to late‐onset CRC. Patients with CRC from 2004 to 2015 in the National Cancer Database were included and categorized by age (under or over 50 years). Differences in demographic and socioeconomic factors, disease characteristics, and survival outcomes between early‐onset versus late‐onset CRC patients were assessed by Chi‐squared test and Cox models. The study population included 1,061,204 patients, 108,058 (10.2%) of whom were under age 50. The proportion of patients diagnosed under age 50 increased over time: 9.4% in 2004–2006, 10.1% in 2007–2009, 10.5% in 2010–2012, and 10.7% in 2013–2015 (p < 0.0001). Early‐onset CRC patients were more likely to be Black (15.1% vs. 11.3%) or Hispanic (8.6% vs. 4.6%) and to present with stage 4 disease (24.9% vs. 17.0%), p < 0.0001 for all. Black patients had the worst median OS (58.3 months) compared to White (67.0 months), Hispanic (91.6 months), or Asian (104.9 months) patients, p < 0.0001. Within the subgroup of early‐onset CRC patients with private insurance, Black patients had worse OS compared to White patients, even in communities with higher income and education status. Early‐onset CRC continues to increase. Patients with early‐onset CRC are more likely to be Black or Hispanic and to present with stage 4 cancer. Early‐onset Black patients showed worse OS compared to White patients in all income subgroups, even with private insurance. Patients with early‐onset colorectal cancer are more likely to be Black or Hispanic and to present with stage 4 cancer. Within the subgroup of early‐onset CRC patients with private insurance, Black patients had worse OS compared to White patients, even in communities with higher income and education status.
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影响因子：
16.9
作者：
Bailey CE;Hu CY;You YN;Bednarski BK;Rodriguez-Bigas MA;Skibber JM;Cantor SB;Chang GJ
通讯作者：
Chang GJ
影响因子：
45.3
作者：
Patel, Manali I.;Lopez, Ana Maria;Tap, William
通讯作者：
Tap, William
影响因子：
2.5
作者：
Parikh, Alexander A.;Robinson, Jamie;Whiteside, Martin A.
通讯作者：
Whiteside, Martin A.
影响因子：
2.5
作者：
Merrill, RM;Brown, ML;Fireman, BH
通讯作者：
Fireman, BH
DOI：
10.3390/ijerph13010048
发表时间：
2015-12-22
影响因子：
--
作者：
Tawk R;Abner A;Ashford A;Brown CP
通讯作者：
Brown CP