Aguilar Daniela Ramirez, Berryhill Johnna, Greer Melody, Gan-Kemp Jennifer, Bhattacharyya Sudeepa
Arkansas Central Cancer Registry, Arkansas Department of Health, Little Rock, Arkansas.
Arkansas State University, Jonesboro, Arkansas.
J Registry Manag. 2024 Winter;51(4):158-166.
Colorectal cancer (CRC) is a common malignancy in the United States, ranking as the third-leading cause of cancer-related deaths. Early detection is crucial for prognosis, treatment, and survival, yet disparities persist in CRC outcomes based on age, sex, race, and geography. In Arkansas, a significant proportion of CRC cases are diagnosed at a late stage, with notable disparities observed among different demographic groups. In this study, we utilized data from the Arkansas Central Cancer Registry (ACCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program to analyze CRC incidence and mortality rates in Arkansas and examine the associated disparities and risk factors. Data were stratified by sex, race, age, geographic area, and stage at diagnosis. Temporal trends and age-adjusted rates were computed using SEER*Stat software, and a bootstrapped logistic regression model was developed to identify predictors of late-stage CRC diagnosis. The analysis revealed that men had higher CRC mortality and incidence rates compared to women, with a mortality rate ratio (MRR) of 1.47 and an incidence rate ratio (IRR) of 1.35. Black individuals exhibited higher CRC mortality and incidence rates than their White counterparts (MRR, 1.46; IRR, 1.29). Late-stage CRC diagnosis was more common among men and individuals of Black race. Temporal trends showed a decline in CRC incidence from 2001 to 2011, followed by an increase from 2011 to 2019. Individuals aged 18-49 years experienced a significant rise in CRC incidence, highlighting an emerging concern for early-onset CRC. Geographic analysis indicated higher CRC incidence in rural vs urban areas. Overall, significant disparities in CRC outcomes were observed by sex, race, age, and geography. The increase in CRC incidence among younger adults underscores the need for targeted screening and early detection strategies. Geographic disparities highlight the necessity of improving health care access and screening services in rural areas.
结直肠癌（CRC）是美国常见的恶性肿瘤，是癌症相关死亡的第三大主要原因。早期检测对于预后、治疗和生存至关重要，但基于年龄、性别、种族和地理位置的结直肠癌结局仍存在差异。在阿肯色州，很大一部分结直肠癌病例在晚期才被诊断出来，不同人口群体之间存在明显差异。在本研究中，我们利用阿肯色州中央癌症登记处（ACCR）和美国国立癌症研究所的监测、流行病学和最终结果（SEER）项目的数据，分析阿肯色州的结直肠癌发病率和死亡率，并研究相关的差异和风险因素。数据按性别、种族、年龄、地理区域和诊断阶段进行分层。使用SEER*Stat软件计算时间趋势和年龄调整率，并建立了一个自抽样逻辑回归模型来确定晚期结直肠癌诊断的预测因素。分析显示，男性的结直肠癌死亡率和发病率高于女性，死亡率比（MRR）为1.47，发病率比（IRR）为1.35。黑人个体的结直肠癌死亡率和发病率高于白人（MRR，1.46；IRR，1.29）。晚期结直肠癌诊断在男性和黑人个体中更为常见。时间趋势显示，2001年至2011年结直肠癌发病率下降，随后2011年至2019年上升。18至49岁的个体结直肠癌发病率显著上升，凸显了对早发性结直肠癌的新关注。地理分析表明，农村地区的结直肠癌发病率高于城市地区。总体而言，在性别、种族、年龄和地理位置方面，结直肠癌结局存在显著差异。年轻成年人中结直肠癌发病率的增加凸显了针对性筛查和早期检测策略的必要性。地理差异突出了改善农村地区医疗保健可及性和筛查服务的必要性。
