Tsai Meng-Han, Shahsavari Dariush, Chen Jie, Moazzami Bobak, Sridhar Subbaramia
Georgia Prevention Institute, Augusta University, 1120 15th Street, HS-1705, Augusta, GA, 30912, USA.
Cancer Prevention, Control, & Population Health Program, Georgia Cancer Center, Augusta University, Augusta, GA, USA.
J Racial Ethn Health Disparities. 2025 Apr 26. doi: 10.1007/s40615-025-02450-5.
Although some researchers have examined EO-CRC clinical presentations, much of this research has focused on non-US populations or single healthcare centers. Limited research has also explored outcomes across diverse racial/ethnic groups. Thus, we examined the relationship of five racial/ethnic groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], American Indian/Alaskan Native [AI/AN], Asian/Pacific Islanders [PI], Hispanic) with EO-CRC tumor characteristics/histologic types and risk of CRC death.
We conducted a retrospective cohort analysis using data from the 2006-2020 Surveillance, Epidemiology, and End Results Program. Multivariable Cox proportional hazards regression and logistical regression models were performed.
Among 46,956 patients, the lower 5-year survival rate was 64.8% among NHB patients (vs. 69.7% for AI/AN, 70.6% for Hispanic, 72.4% for Asian/PI, and 73.4% for NHW patients, p-value < 0.001). In multivariable analysis, NHB, Asian/PI, and Hispanic patients were 10-12% more likely to have late stage at diagnosis and had increased risk of CRC death by 9-37% than NHW patients (p-value < 0.05). Further, NHB patients were 52% more likely to have a right-sided CRC (OR, 1.52; 95% CI, 1.43-1.61), Asian/PI were 15% more likely to have high pathological grading (OR, 1.15; 95% CI, 1.06-1.25), and Hispanic patients were 25% more likely to have MAC/SC subtype (OR, 1.25; 95% CI, 1.16-1.35).
Effective patient-centered communication tailored to the specific needs of racial and ethnic minorities through primary care initiatives may have potential for improving early detection and outcomes, particularly for younger populations and racial minorities.
尽管一些研究人员已对早发性结直肠癌（EO-CRC）的临床表现进行了研究，但大部分此类研究聚焦于非美国人群或单一医疗中心。有限的研究也探讨了不同种族/族裔群体的结局。因此，我们研究了五个种族/族裔群体（非西班牙裔白人[NHW]、非西班牙裔黑人[NHB]、美国印第安人/阿拉斯加原住民[AI/AN]、亚裔/太平洋岛民[PI]、西班牙裔）与EO-CRC肿瘤特征/组织学类型以及结直肠癌死亡风险之间的关系。
我们使用2006 - 2020年监测、流行病学和最终结果计划的数据进行了一项回顾性队列分析。进行了多变量Cox比例风险回归和逻辑回归模型分析。
在46,956名患者中，NHB患者的5年生存率较低，为64.8%（相比之下，AI/AN患者为69.7%，西班牙裔患者为70.6%，亚裔/PI患者为72.4%，NHW患者为73.4%，p值<0.001）。在多变量分析中，NHB、亚裔/PI和西班牙裔患者在诊断时处于晚期的可能性比NHW患者高10 - 12%，结直肠癌死亡风险增加9 - 37%（p值<0.05）。此外，NHB患者患右侧结直肠癌的可能性高52%（比值比[OR]，1.52；95%置信区间[CI]，1.43 - 1.61），亚裔/PI患者有高病理分级的可能性高15%（OR，1.15；95% CI，1.06 - 1.25），西班牙裔患者有黏液腺癌/印戒细胞癌（MAC/SC）亚型的可能性高25%（OR，1.25；95% CI，1.16 - 1.35）。
通过初级保健举措，针对种族和少数族裔的特定需求进行有效的以患者为中心的沟通，可能有改善早期检测和结局的潜力，特别是对于年轻人群体和少数族裔。
