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Published on: June 8, 2020
Sociodemographic Risk Factors in Therapy Delays and Associated Increased Mortality Among Colorectal Cancer Patients
Hassam Ali1, Vishali Moond2, Dushyant Singh Dahiya3
1Department of Gastroenterology, ECU Health Medical Center, 2100 Stantonsburg Road, Greenville, NC, 27834, USA. hassamali155@gmail.com.
Introduction:
We investigated the impact of racial/ethnic disparities in therapy initiation on colorectal cancer (CRC) mortality using Surveillance, Epidemiology, and End Results Program (SEER) database.
Methods:
Adults aged 18-84 years with CRC were identified. Cox models for 60-month all-cause and cancer-specific mortality were adjusted for demographics, stage, tumor site, income, and rural-urban residence.
Results:
Therapy initiation was slower for Hispanics (HR 0.85) and non-Hispanic Black (NHB) patients (HR 0.80) compared with non-Hispanic Whites (p < 0.001). Each additional month of delay was associated with a 3% increase in cancer mortality (p < 0.001). Findings were consistent across diagnosis eras, with no significant race-by-era interaction, and adjustment for socioeconomic and geographic factors resulted in minimal attenuation of racial disparities.
Conclusion:
Treatment delays independently contribute to all-cause and cancer-specific mortality, disproportionately affecting NHB and lower-SES patients.
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