Colorectal Cancer Outcomes Among Disaggregated Asian Subgroups: a 2006-2020 SEER Analysis

Area of Science:

• Oncology
• Public Health
• Health Disparities

Background:

• Colorectal cancer (CRC) outcomes often show significant variation among distinct Asian American subgroups.
• However, Asian individuals are frequently analyzed in aggregate, masking these differences.
• This study addresses the need for disaggregated analyses to understand CRC outcome heterogeneity.

Purpose of the Study:

• To assess heterogeneity in CRC outcomes across the six largest Asian origin groups in the United States.
• To identify specific Asian American subgroups with differing CRC diagnoses and survival rates.
• To inform culturally relevant approaches to CRC prevention and care.

Main Methods:

• Utilized Surveillance, Epidemiology, and End Results (SEER) registry data from 2006-2020.
• Included adults with a primary diagnosis of CRC from six major Asian origin groups and a non-Hispanic White (NHW) referent group.
• Employed multivariable logistic regression for stage at diagnosis and Cox proportional hazards models for CRC-related death.

Main Results:

• The cohort comprised 25,379 Asian Americans (Chinese, Filipino, Japanese, Vietnamese, Korean, Asian Indian/Pakistani) and 234,938 NHW individuals.
• Vietnamese, Korean, and Asian Indian/Pakistani individuals had increased odds of regional or distant stage CRC at diagnosis compared to NHW.
• Chinese and Asian Indian/Pakistani individuals showed a decreased likelihood of CRC-related death compared to NHW.

Conclusions:

• Significant heterogeneity in CRC stage and survival was observed across disaggregated Asian American groups.
• Disaggregated analyses are crucial for accurate CRC trend surveillance and identifying high-risk populations.
• Tailored, culturally relevant strategies are essential for CRC prevention and care.