Department of Internal Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (AJNT).
Queen's Liver Center, Queen's Transplant Center, The Queen's Medical Center, Honolulu, HI; Department of Internal Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (CTT).
Hawaii J Health Soc Welf. 2024 Oct;83(10):279-285. doi: 10.62547/AEBM4307.
Despite advances in diagnosis and treatment, racial disparities continue to exist in colorectal cancer (CRC) survival. This study aims to characterize the CRC survival differences among racial and ethnic minority groups. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify adults diagnosed with CRC from 2015 to 2019. Demographics, disease characteristics, surgical treatment, stages, and survival data for individuals who are Hispanic, Black, Southeast Asian, Chinese, American Indian and Alaskan Native (AIAN), Asian Indian and Pakistani (AIP), and Native Hawaiian and Other Pacific Islanders (NHOPI) were extracted. Survival analysis was done using the Kaplan-Meier survival curve. Multivariate analysis was done with the Cox proportional hazard model. There were 40 091 individuals with CRC. NHOPI had the youngest median age of 59 years, while Chinese individuals had the oldest median age of 65 years. From the total sample of their respective subgroups, 43.8% of Black patients and 36.7% of AIAN patients had a median household income of <$60 000, while 55.3% of Southeast Asian patients, 59.7% of Chinese patients, 55.8% of AIP patients, and 65.6% of NHOPI patient had a median household income >$70 000. The 1-year survival rate was lower for patients who were Hispanic (62.0%), Black (60.9%), and AIAN (63.1%). Even after multivariate analysis, Black patients had a significant hazard ratio (HR) of 1.21 (95% confidence interval [95% CI]: 1.05-1.38), while AIP had a HR of 0.68 (95% CI 0.55-0.84), compared to AIAN. Other significant variables that were linked with survival included older age, advanced stage of CRC, a median household income <$60 000, male sex, no surgery, subtotal colectomy/hemicolectomy, and total colectomy. Further studies are needed to elucidate the specific causes of these differences and create appropriate strategies to reduce this survival disparity.
尽管在诊断和治疗方面取得了进展,但结直肠癌(CRC)的生存仍存在种族差异。本研究旨在描述少数族裔群体之间 CRC 生存差异的特征。使用监测、流行病学和最终结果(SEER)数据库确定了 2015 年至 2019 年间诊断为 CRC 的成年人。提取了西班牙裔、黑种人、东南亚人、中国人、美洲印第安人和阿拉斯加原住民(AIAN)、亚裔印度人和巴基斯坦人(AIP)、夏威夷原住民和其他太平洋岛民(NHOPI)个体的人口统计学、疾病特征、手术治疗、分期和生存数据。使用 Kaplan-Meier 生存曲线进行生存分析。使用 Cox 比例风险模型进行多变量分析。共有 40091 名 CRC 患者。NHOPI 的中位年龄最小,为 59 岁,而中国人的中位年龄最大,为 65 岁。在各自亚组的总样本中,43.8%的黑人患者和 36.7%的 AIAN 患者的家庭中位收入<60000 美元,而 55.3%的东南亚患者、59.7%的中国人、55.8%的 AIP 患者和 65.6%的 NHOPI 患者的家庭中位收入>70000 美元。西班牙裔(62.0%)、黑种人(60.9%)和 AIAN(63.1%)患者的 1 年生存率较低。即使经过多变量分析,黑人患者的危险比(HR)仍显著为 1.21(95%置信区间[95%CI]:1.05-1.38),而 AIP 患者的 HR 为 0.68(95%CI 0.55-0.84),与 AIAN 相比。与生存相关的其他显著变量包括年龄较大、CRC 晚期、家庭中位收入<60000 美元、男性、无手术、次全结肠切除术/半结肠切除术和全结肠切除术。需要进一步研究以阐明这些差异的具体原因,并制定适当的策略来减少这种生存差异。