Results of a large retrospective study of young adults diagnosed with colorectal cancer showed that residing in an area populated by individuals with low income and education levels was associated with an increased risk of death. The findings from this study will be presented at the 2020 Gastrointestinal Cancers Symposium in San Francisco, California.1
Although recent studies have identified a rising incidence of colorectal cancer in adults 40 years or younger, few investigations have focused on the extent to which specific sociodemographic characteristics may be contributing to health outcomes.
Study coauthor Mohamed E. Salem, MD, gastrointestinal oncologist and associate professor of medicine at Levine Cancer Institute in Charlotte, North Carolina, noted in a press release that “although awareness of health care disparities has increased, considerable knowledge gaps still exist, particularly among young adults with cancer.”2
In the current analysis, the National Cancer Database was mined for information related to clinicopathological and sociodemographic characteristics of 24,768 US adults who were diagnosed with colorectal cancer at 40 years or younger.
The percentages of men and women included in the analysis were similar (eg, 51.6% were men), and 78.7%, 14.4%, and 6.6% of participants were classified as white, black, or as being from another racial group, respectively.
Of these individuals, 32.3% and 18.4% of patients were classified as living in an area with the highest median annual income ($68,000 or more) and the lowest median annual income (less than $38,000), respectively. Regarding the education level of the area of residence, 23% and 20% lived in an areas with the highest (more than 93%) and lowest (less than 79%) high school graduation rates, respectively.
Patients living in areas characterized by the lowest income and lowest education level were significantly more likely to be black (odds ratio [OR], 6.4; 95% CI, 5.6-7.4) and to lack private insurance (OR, 6.3; 95% CI, 5.6-7.0) compared with those residing in areas with the highest income and highest education level. Furthermore, black patients were more likely to have advanced disease and comorbidities, and less likely to have undergone surgery compared with patients residing in communities with more favorable socioeconomic positions.
Following adjustments for race, insurance status, clinical stage based on tumor size and nodal status, and Charlson-Deyo comorbidity score, the risk of death was determined to be significantly higher for patients living in areas characterized by the lowest income and education levels compared with in areas characterized by the highest income and education levels (hazard [HR], 1.24; 95% CI, 1.1-1.44; P =.004).
In their concluding remarks, the study authors called for improved efforts “to eliminate disparities and achieve health equity.”
Disclosures: Some of the study authors reported financial relationships with pharmaceutical or medical device companies. For a full list of disclosures, please refer to the study abstract.
- Matusz-Fisher A, Trufan SJ, Kadakia KC, et al. Sociodemographic disparities in young adults with colorectal cancer (CRC): Analysis of 26,768 patients in the National Cancer Database (NCDB). J Clin Oncol. 2020;38(suppl 4):Abstract 13.
- 2020 Gastrointestinal Cancers Symposium. Young adults with colorectal cancer in low-income and low-education areas, or urban areas, have worse overall survival and a higher risk of death [press release]. Published January 21, 2020. Accessed January 23, 2020.
This article originally appeared on Cancer Therapy Advisor