Impact of Race and Socioeconomics Disparities on Survival in Young-Onset Colorectal Adenocarcinoma—A SEER Registry Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Source
2.3. Patient Selection
2.4. Socioeconomic Determinants of Health (SEDH)
2.5. Statistical Analysis
3. Results
3.1. Completion of High School Education (above vs. below 50th Centile)
3.2. Poverty (above vs. below 50th Centile)
3.3. Employment Status (above vs. below 50th Centile)
3.4. Household Income with Reference to the Median (above vs. below 50th Centile
3.5. Marital (Married) Status (above vs. below 50th Centile)
3.6. Insurance (Commercial vs. Medicaid)
3.7. Recent Immigration to the U.S. (above vs. below 50th Centile)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Hispanic | Non-Hispanic American Indian | Non-Hispanic Asian Pacific Islander | Non-Hispanic Black | Non-Hispanic White | Total | ||
---|---|---|---|---|---|---|---|
n = 2874 | n = 164 | n = 1676 | n = 2305 | n =10,126 | n = 17,145 | ||
Age Range | 25–29 years | 127 | 7 | 52 | 61 | 292 | 539 |
30–34 years | 288 | 1 4 | 113 | 141 | 717 | 1273 | |
35–39 years | 487 | 28 | 217 | 294 | 1287 | 2313 | |
40–44 years | 755 | 40 | 464 | 595 | 2702 | 4556 | |
45–49 years | 1217 | 75 | 830 | 1214 | 5128 | 8464 | |
Sex | Female | 1371 | 77 | 846 | 1201 | 4754 | 8249 |
Male | 1503 | 87 | 830 | 1104 | 5372 | 8896 | |
Primary Site | Appendix | 95 | 8 | 37 | 57 | 304 | 501 |
Ascending Colon | 263 | 15 | 121 | 345 | 803 | 1547 | |
Cecum | 252 | 9 | 115 | 348 | 922 | 1646 | |
Colon NOS | 23 | 1 | 7 | 9 | 55 | 95 | |
Descending | 182 | 8 | 126 | 179 | 526 | 1021 | |
Hepatic Flexure | 73 | 5 | 52 | 64 | 209 | 403 | |
Overlapping | 30 | 1 | 11 | 24 | 67 | 133 | |
Rectosigmoid | 274 | 19 | 190 | 159 | 1118 | 1760 | |
Rectum | 668 | 42 | 457 | 353 | 2807 | 4327 | |
Sigmoid | 751 | 45 | 437 | 534 | 2569 | 4336 | |
Splenic Flexure | 69 | 2 | 42 | 65 | 226 | 404 | |
Transverse Colon | 194 | 9 | 81 | 168 | 520 | 972 | |
Histology | Adenocarcinoma, NOS | 1923 | 119 | 1224 | 1554 | 6839 | 11,659 |
Adenocarcinoma In adenomatous polyp | 198 | 11 | 105 | 186 | 994 | 1494 | |
Tubular Adenocarcinoma | 1 | 0 | 0 | 1 | 4 | 6 | |
Serrated Adenocarcinoma | 0 | 0 | 0 | 0 | 1 | 1 | |
Adenocarcinoma in adenomatous polyposis coli | 11 | 0 | 3 | 4 | 17 | 35 | |
Adenocarcinoma in multiple Adenomatous polyps | 3 | 0 | 2 | 2 | 2 | 9 | |
Adenocarcinoma in villous adenoma | 79 | 1 | 25 | 54 | 213 | 372 | |
Villous Adenocarcinoma | 1 | 0 | 1 | 2 | 2 | 6 | |
Adenocarcinoma in tubulovillous adenoma | 267 | 17 | 154 | 248 | 1039 | 1725 | |
Clear cell Adenocarcinoma, NOS | 1 | 0 | 0 | 0 | 2 | 3 | |
Cystadenocarcinoma, NOS | 1 | 0 | 0 | 0 | 1 | 2 | |
Mucinous cystadenocarcinoma, NOS | 2 | 0 | 1 | 2 | 8 | 13 | |
Mucinous adenocarcinoma | 308 | 11 | 117 | 190 | 788 | 1414 | |
Mucin- producing adenocarcinoma | 27 | 1 | 6 | 22 | 52 | 108 | |
Signet ring cell carcinoma | 51 | 4 | 37 | 40 | 161 | 293 | |
Grade | Well differentiated; Grade I | 279 | 14 | 111 | 157 | 698 | 1259 |
Moderately differentiated; Grade II | 1901 | 110 | 1126 | 1592 | 6884 | 11,613 | |
Poorly differentiated; Grade Ill | 420 | 23 | 287 | 316 | 1452 | 2498 | |
Undifferentiated; anaplastic; Grade IV | 79 | 4 | 38 | 73 | 338 | 532 | |
Mucinous | Non-Mucinous | 2566 | 153 | 1559 | 2115 | 9338 | 15,731 |
Mucinous | 308 | 11 | 117 | 190 | 788 | 1414 | |
AJCC-7 TNM | 0 | 96 | 2 | 48 | 77 | 293 | 516 |
I | 469 | 30 | 276 | 385 | 1917 | 3077 | |
IIA | 589 | 42 | 341 | 429 | 1922 | 3323 | |
IIB | 70 | 1 | 28 | 49 | 212 | 360 | |
IIC | 84 | 4 | 27 | 50 | 192 | 357 | |
IIIA | 109 | 7 | 56 | 112 | 452 | 736 | |
IIIB | 684 | 27 | 426 | 524 | 2409 | 4070 | |
IIIC | 281 | 15 | 161 | 202 | 890 | 1549 | |
IVA | 284 | 20 | 161 | 259 | 1058 | 1782 | |
IVB | 184 | 14 | 1 43 | 204 | 702 | 1247 | |
IVC | 24 | 2 | 9 | 14 | 79 | 128 | |
Procedure | Colectomy or proctocolectomy resection in continuity | 61 | 0 | 27 | 27 | 150 | 265 |
Colectomy, NOS; Proctectomy, NOS | 11 | 1 | 7 | 11 | 22 | 52 | |
Cryosurgery | 0 | 0 | 0 | 0 | 1 | 1 | |
Electrocautery fulguration (hot forceps) | 2 | 0 | 0 | 0 | 2 | 4 | |
Endoscopic polypectomy | 42 | 1 | 32 | 36 | 144 | 255 | |
Excisional biopsy | 16 | 2 | 9 | 14 | 104 | 145 | |
Hemicolectomy or subtotal colectomy | 844 | 47 | 429 | 917 | 2769 | 5006 | |
Hemicolectomy or subtotal colectomy (and resection) | 81 | 8 | 40 | 100 | 233 | 462 | |
Local tumor destruction, NOS | 1 | 0 | 1 | 1 | 0 | 3 | |
Local tumor excision, electrocautery | 11 | 2 | 4 | 5 | 35 | 57 | |
Local tumor excision, laser ablation | 1 | 0 | 0 | 0 | 1 | 2 | |
Local tumor excision, laser excision | 1 | 0 | 0 | 0 | 0 | 1 | |
Local tumor excision, NOS | 13 | 1 | 4 | 8 | 32 | 58 | |
Partial colectomy (segmental resection) | 1369 | 78 | 890 | 869 | 5145 | 8351 | |
Polypectomy, NOS | 56 | 2 | 48 | 63 | 246 | 415 | |
Surgical polypectomy | 6 | 1 | 1 | 7 | 16 | 31 | |
Total colectomy | 209 | 12 | 107 | 122 | 679 | 1129 | |
Total colectomy (& resection of a contiguous organ) | 11 | 1 | 6 | 8 | 52 | 78 | |
Total colectomy with ileorectal reconstruction | 0 | 0 | 0 | 1 | 2 | 3 | |
Total colectomy with ileostomy, NOS | 1 | 0 | 1 | 0 | 4 | 6 | |
Total colectomy with Pouch | 1 | 0 | 0 | 0 | 1 | 2 | |
Total proctocolectomy (& resection of a contiguous organ) | 3 | 0 | 1 | 5 | 10 | 19 | |
Total proctocolectomy with ileostomy (NOS) | 1 | 1 | 0 | 2 | 6 | 10 | |
Total proctocolectomy with ileostomy & Pouch | 3 | 0 | 0 | 0 | 7 | 10 | |
Total proctocolectomy, NOS | 36 | 0 | 28 | 29 | 184 | 277 | |
Unknown if surgery performed; death certificate ON | 26 | 3 | 8 | 17 | 56 | 110 | |
Wedge resection (segmental resection) & resection | 68 | 4 | 33 | 63 | 225 | 393 |
Hispanic | Non-Hispanic American | Non-Hispanic Asian or Pacific Islander | Non-Hispanic Black | Non-Hispanic White | |
---|---|---|---|---|---|
Indian/Alaskan | |||||
Native | |||||
Marital Status (Unmarried vs. Married) | |||||
Immigration (Above vs. Below 50th centile) | |||||
Employment Status (Above vs. Below 50th centile) | |||||
Poverty (Above vs. Below 50th centile) | |||||
High School Education (Above vs. Below 50th centile) | |||||
Insurance (Medicaid vs. Commercial) | |||||
Household Income (Above vs. Below 50th centile) |
Univariate Analysis | Multivariate Analysis | ||||||
---|---|---|---|---|---|---|---|
Socioeconomic Determinant | HR | CI | p | Socioeconomic Determinant | HR | CI | p |
Immigration | 1.081 | 1.002–1.165 | 0.043 | Immigration | 1.011 | 0.927–1.102 | 0.808 |
Employment Status | 0.89 | 0.826–0.96 | 0.002 | Unemployment | 1.006 | 0.91–1.112 | 0.809 |
Poverty | 0.811 | 0.753–0.875 | 0.001 | Poverty | 0.887 | 0.787–0.999 | 0.049 |
High School Education | 0.795 | 0.738–0.857 | <0.0001 | High School Education | 0.875 | 0.791–0.967 | 0.009 |
Insurance (Commercial vs. Medicaid) | 0.54 | 0.494–0.592 | <0.0001 | Insurance (Commercial vs. Medicaid) | 0.597 | 0.542–0.659 | <0.0001 |
Unmarried vs. Married | 1.436 | 1.331–1.55 | <0.0001 | Unmarried vs. Married | 1.305 | 1.201–1.419 | <0.0001 |
Household Income | 1.26 | 1.169–1.357 | 0.001 | Household Income | 1.136 | 0.994–1.1298 | 0.062 |
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Share and Cite
Aloysius, M.M.; Goyal, H.; Shah, N.J.; Pallav, K.; John, N.; Gajendran, M.; Perisetti, A.; Tharian, B. Impact of Race and Socioeconomics Disparities on Survival in Young-Onset Colorectal Adenocarcinoma—A SEER Registry Analysis. Cancers 2021, 13, 3262. https://doi.org/10.3390/cancers13133262
Aloysius MM, Goyal H, Shah NJ, Pallav K, John N, Gajendran M, Perisetti A, Tharian B. Impact of Race and Socioeconomics Disparities on Survival in Young-Onset Colorectal Adenocarcinoma—A SEER Registry Analysis. Cancers. 2021; 13(13):3262. https://doi.org/10.3390/cancers13133262
Chicago/Turabian StyleAloysius, Mark M., Hemant Goyal, Niraj J. Shah, Kumar Pallav, Nimy John, Mahesh Gajendran, Abhilash Perisetti, and Benjamin Tharian. 2021. "Impact of Race and Socioeconomics Disparities on Survival in Young-Onset Colorectal Adenocarcinoma—A SEER Registry Analysis" Cancers 13, no. 13: 3262. https://doi.org/10.3390/cancers13133262