A. Ewongwo1, J. Koblinski1, K. Hanna1, Z. Alattar1, O. Ayotunde1, O. Ojameruaye1, T. Lin1, E. Thompson1, R. Flomo1, V. Nfonsam1 1University Of Arizona,General Surgery,Tucson, AZ, USA
Introduction:
Colorectal cancer (CRC) remains a leading cause of cancer-related deaths in the United States. Multiple reports highlighted the existence of racial disparities between African Americans (AA)and Whites for the incidence of late-onset (LO) CRC. However, the potential disparities in the incidence amongst early-onset (EO) CRC remains relatively less explored. The aim of our study was to evaluate racial disparities in the incidence of colon cancer (CC) and rectal cancer (RC) queried nationally.
Methods:
We conducted a six-year analysis (2010-2015) of the nationwide inpatient sample (NIS) database. We obtained the national estimates of CC and RC for AA and Whites. We analyzed trends in incidence for early-onset (EO) (<50 years old) and LO (>50 years old) CC and RC. We compared outcomes such as mortality, complications, and stage of disease between African Americans and Whites. Cochrane trend analysis was performed.
Results:
The overall incidence of CC and RC increased by 2% and 3%, respectively in AA; while the overall incidence of CC and RC remained stable respectively in white patients. The incidence of EO CC and RC increased by 3% and 6% in AA and by 4% and 4% respectively in White. For LO CC, the incidence increased by 4% in AA while it remained stable in Whites and for LO RC, the trend in incidence increased in AA by 2% but decreased in Whites by 3%. Patients who were White had a significantly lower mortality (4% vs. 9%; p=0.01), lower in-hospital complications (8% vs. 13%; p=0.01), and less advanced stage disease on presentation (19% vs. 34%; p<0.01) in comparison to AA.
Conclusion:
Racial disparities do exist in the incidence of CC and RC between Whites and AA with increasing incidence seen in AA. In addition, AA present with more advanced disease and have worse outcomes. Understanding the reasons behind such disparities is needed to develop public health interventions.