P2604 - Consideration of Race and Ethnicity in Evaluating Outcomes of Colorectal Cancer With Increasing Age

Dhruvi Sanikommu, MD¹, Abdullah Hafeez, MD¹, Omar Alkasabrah, MD¹, Steve Kwon, MD², Ponnandai Somasundar, MD², Lidia Vognar, MD², Joanna Chebl, MD²
1Landmark Medical Center, Woonsocket, RI; 2Roger Williams Medical Center, Providence, RI

Introduction: Accelerated biological aging in certain racial/ethnic groups has been described with concern for widening disparities with increasing age. With the lack of evidence for cancer patients, we sought to determine the relationship of racial/ethnic disparities in colorectal cancer (CRC) outcomes and age.

Methods: Retrospective analysis of National Cancer Database from 2010 to 2021 was performed using age at diagnosis of CRC for cohorts: < 65, 65-69, 70-74, 75-79, and ≥80 years. Race/ethnicity included: non-Hispanic White, Black, Hispanic, Asian/Pacific Islander (API), and American Indian/Aleutian/Eskimo (AIAE). Primary outcomes were overall survival (OS) and 90-day postoperative mortality (PM) after surgery. We used multivariable Cox proportional hazard and logistic regression models.

Results: The median OS in Blacks ranged from 64.13 months in < 65 years cohort (vs. 126.98 months for Whites; HR 1.28, 95%CI 1.26-1.30) and 19.15 months in ≥80 years cohort (vs. 26.45 months for Whites; HR 1.06, 95%CI 1.03-1.09). The Hispanic and API race/ethnicity were associated with improved OS compared to Whites. The 90-day PM showed similar trends between Black and White patients with OR 1.23 (95%CI 1.15-1.31) in the < 65 years cohort and OR 1.11 (95%CI 1.01-1.22) in the ≥80 years cohort. Notably, AIAE race was associated with an increased 90-day PM in 70-74 years (OR 2.65, 95%CI 1.67-4.20) and 75-79 years (OR 1.94, 95%CI 1.07-3.53) cohorts but had similar OS compared to Whites.

Discussion: While disparities persist throughout age, in contrast to non-oncological literature, we found larger racial/ethnic outcome disparities in younger age groups for those with CRC except in AIAEs.


Figure: Median survival by race/ethnicity in different age groups


Figure: Table 1. Multivariate analysis of overall survival in different race/ethnic groups stratified by age groups. Expressed as Hazard Ratio and 95% Confidence Interval.
Comparison groups are: males for Sex, stage 0 for stage, colon for location of primary Non-Hispanic White for race/ethnicity

Disclosures:
Dhruvi Sanikommu indicated no relevant financial relationships.
Abdullah Hafeez indicated no relevant financial relationships.
Omar Alkasabrah indicated no relevant financial relationships.
Steve Kwon indicated no relevant financial relationships.
Ponnandai Somasundar indicated no relevant financial relationships.
Lidia Vognar indicated no relevant financial relationships.
Joanna Chebl indicated no relevant financial relationships.

Dhruvi Sanikommu, MD¹, Abdullah Hafeez, MD¹, Omar Alkasabrah, MD¹, Steve Kwon, MD², Ponnandai Somasundar, MD², Lidia Vognar, MD², Joanna Chebl, MD². P2604 - Consideration of Race and Ethnicity in Evaluating Outcomes of Colorectal Cancer With Increasing Age, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.