Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Los Angeles Cancer Surveillance Program, University of Southern California, Los Angeles, California, USA.
Cancer Med. 2023 Nov;12(22):20976-20988. doi: 10.1002/cam4.6653. Epub 2023 Nov 1.
Colorectal cancer (CRC) is the third most common cancer in California and second among Hispanic/Latinx (H/L) males. Data from the California Cancer Registry were utilized to investigate the differential impact on CRC outcomes from demographic and clinical characteristics among non-Hispanic white (NHW), non-Hispanic Black (NHB), U.S. born (USB), and non-U.S. born (NUSB) H/L patients diagnosed during 1995-2020.
We identified 248,238 NHW, 28,433 NHB, and 62,747 H/L cases (32,402 NUSB and 30,345 USB). Disparities across groups were evaluated through case frequencies, odds ratios (OR) from logistic regression, and hazard ratios (HR) from Cox regression models. All statistical tests were two-sided.
NHB patients showed a higher proportion of colon tumors (75.8%) than NHW (71.5%), whereas both NUSB (65.9%) and USB (66.9%) H/L cases had less (p < 0.001). In multivariate models, NUSB H/L cases were 15% more likely than NHW to have rectal cancer. Compared to NHW, NHB cases had the greatest proportion of Stage IV diagnoses (26.0%) and were more likely to die of CRC (multivariate HR = 1.12; 95% CI = 1.10-1.15). Instead, NUSB H/L patients were less likely to die of CRC (multivariate HR = 0.87; 95% CI = 0.85-0.89) whereas USB H/L did not differ from NHW.
NHB and H/L cases have more adverse characteristics at diagnosis compared to NHW cases, with NHB cases being more likely to die from CRC. However, NUSB H/Ls cases showed better survival than NHW and US born H/L patients. These findings highlight the importance of considering nativity among H/L populations to understand cancer disparities.
在加利福尼亚州，结直肠癌（CRC）是第三大常见癌症，也是西班牙裔/拉丁裔（H/L）男性中的第二大常见癌症。利用加利福尼亚癌症登记处的数据，调查了 1995 年至 2020 年期间诊断的非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）、美国出生（USB）和非美国出生（NUSB）H/L 患者中，人口统计学和临床特征对 CRC 结局的差异影响。
我们确定了 248238 名 NHW、28433 名 NHB 和 62747 名 H/L 病例（32402 名 NUSB 和 30345 名 USB）。通过病例频率、逻辑回归的优势比（OR）和 Cox 回归模型的风险比（HR）评估组间差异。所有统计检验均为双侧。
NHB 患者的结肠癌比例（75.8%）高于 NHW（71.5%），而 NUSB（65.9%）和 USB（66.9%）H/L 病例的结肠癌比例较低（p<0.001）。在多变量模型中，NUSB H/L 病例比 NHW 更有可能患有直肠癌。与 NHW 相比，NHB 病例 IV 期诊断比例最高（26.0%），死于 CRC 的可能性更高（多变量 HR=1.12；95%CI=1.10-1.15）。相比之下，NUSB H/L 患者死于 CRC 的可能性较低（多变量 HR=0.87；95%CI=0.85-0.89），而 USB H/L 与 NHW 无差异。
与 NHW 病例相比，NHB 和 H/L 病例在诊断时具有更多不利特征，NHB 病例死于 CRC 的可能性更大。然而，NUSB H/L 病例的生存情况好于 NHW 和美国出生的 H/L 患者。这些发现强调了在 H/L 人群中考虑原籍国以了解癌症差异的重要性。
