A NEW cohort study highlights significant racial and ethnic disparities in mortality rates associated with early-onset colorectal cancer (EOCRC).
The study analysed data from the California Cancer Registry for 22,834 individuals diagnosed between 2000–2019. Among the participants (median age: 44 years; 53.5% male), racial and ethnic identity included 45.9% non-Hispanic White, 30.2% Hispanic, 15.5% Asian American, 7.3% non-Hispanic Black, 0.6% Native Hawaiian or Other Pacific Islander, and 0.5% non-Hispanic American Indian or Alaska Native. Median follow-up was 4.2 years.
Compared with non-Hispanic White individuals, higher EOCRC mortality was observed for Native Hawaiian or Other Pacific Islander (adjusted hazard ratio [AHR]: 1.34; 95% CI: 1.01–1.76) and non-Hispanic Black (AHR: 1.18; 95% CI: 1.07–1.29) individuals. Hispanic individuals initially showed higher mortality (AHR: 1.15; 95% CI: 1.08–1.22), but this association diminished after adjusting for neighbourhood socioeconomic status (AHR: 1.00; 95% CI: 0.94–1.06).
For Asian American subgroups, notable heterogeneity was observed, though no single group exhibited elevated mortality risk after adjusting for covariates. For Southeast Asian individuals, initial increased mortality risk disappeared after accounting for insurance status.
The findings emphasise the critical role of social determinants such as neighbourhood socioeconomic status and insurance coverage in EOCRC outcomes, highlighting the highest burden of EOCRC mortality among Native Hawaiian or Other Pacific Islander and non-Hispanic Black populations.
These disparities reinforce the need for targeted interventions to address health inequities and improve outcomes for vulnerable populations. Enhanced understanding of the social drivers of EOCRC mortality could inform policies to mitigate these disparities and ensure equitable cancer care.
Ada Enesco, EMJ
Reference
Demb J et al. Racial and ethnic variation in survival in early-onset colorectal cancer. JAMA Netw Open. 2024;7(11):e2446820.
