Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Department of Medicine, School of Medicine, University of California Irvine, Irvine, California.
Cancer Epidemiol Biomarkers Prev. 2023 Jun 1;32(6):795-801. doi: 10.1158/1055-9965.EPI-22-1326.
Literature on colorectal cancer outcomes in individuals of Middle Eastern and North African (MENA) descent is limited. To address this gap, we estimated five-year colorectal cancer-specific survival by race and ethnicity, including MENA individuals, in a diverse, population-based sample in California.
We identified adults (ages 18-79 years) diagnosed with a first or only colorectal cancer in 2004 to 2017 using the California Cancer Registry (CCR), including non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic, and MENA individuals. For each racial/ethnic group, we calculated five-year colorectal cancer-specific survival and used Cox proportional hazards regression models to examine the association of race/ethnicity and survival, adjusting for clinical and socio demographic factors.
Of 110,192 persons diagnosed with colorectal cancer, five-year colorectal cancer-specific survival was lowest in Black (61.0%) and highest in MENA (73.2%) individuals. Asian (72.2%) individuals had higher survival than White (70.0%) and Hispanic (68.2%) individuals. In adjusted analysis, MENA [adjusted HR (aHR), 0.82; 95% confidence interval (CI), 0.76-0.89], Asian (aHR, 0.86; 95% CI, 0.83-0.90), and Hispanic (aHR, 0.94; 95% CI, 0.91-0.97) race/ethnicity were associated with higher, and Black (aHR, 1.13; 95% CI, 1.09-1.18) race/ethnicity was associated with lower survival compared with non-Hispanic White race/ethnicity.
To our knowledge, this is the first study to report colorectal cancer survival in MENA individuals in the United States. We observed higher survival of MENA individuals compared with other racial/ethnic groups, adjusting for sociodemographic and clinical factors.
Future studies are needed to identify factors contributing to cancer outcomes in this unique population.
中东和北非(MENA)血统的个体的结直肠癌结局的文献有限。为了解决这一差距,我们在加利福尼亚州的一个多样化的人群基础样本中,按种族和民族估计了包括 MENA 个体在内的五年结直肠癌特异性生存率。
我们使用加利福尼亚癌症登记处(CCR)确定了 2004 年至 2017 年间诊断为首次或唯一结直肠癌的成年人(年龄 18-79 岁),包括非西班牙裔白人、非西班牙裔黑人、非西班牙裔亚洲人、西班牙裔和 MENA 个体。对于每个种族/民族群体,我们计算了五年结直肠癌特异性生存率,并使用 Cox 比例风险回归模型检查了种族/民族与生存率之间的关联,同时调整了临床和社会人口统计学因素。
在诊断为结直肠癌的 110192 人中,黑人(61.0%)和 MENA 个体(73.2%)的五年结直肠癌特异性生存率最低,亚洲人(72.2%)的生存率高于白人(70.0%)和西班牙裔(68.2%)。在调整分析中,MENA[调整后的 HR(aHR),0.82;95%置信区间(CI),0.76-0.89]、亚洲人(aHR,0.86;95%CI,0.83-0.90)和西班牙裔(aHR,0.94;95%CI,0.91-0.97)与生存率较高相关,而黑人(aHR,1.13;95%CI,1.09-1.18)与非西班牙裔白人种族/民族相比,与生存率较低相关。
据我们所知,这是第一项报告美国 MENA 个体结直肠癌生存情况的研究。我们观察到 MENA 个体的生存率高于其他种族/民族群体,同时调整了社会人口统计学和临床因素。
需要进一步的研究来确定导致这一独特人群癌症结局的因素。