An evaluation of a large cohort of colorectal cancer patients has revealed substantial racial disparities in overall survival and some interesting differences in driver mutations.
“We found the difference in racial groups is not only about socioeconomic status but also about the contribution of cancer biology,” said Mahmoud Yousef, MD, a postdoctoral research fellow in GI oncology at The University of Texas MD Anderson Cancer Center, in Houston.
Significant disparities in CRC mortality have long been observed among different racial groups, but they most commonly have been attributed to unequal access to healthcare and associated delays in diagnosis and treatment. Dr. Yousef and his co-investigators conducted a systematic investigation of molecular, socioeconomic and clinical covariates within a data set of 47,178 patients with CRC to quantitate the degree to which each variable might influence overall survival.
Overall survival was lowest for African American patients and highest for Asian patients; Hispanic patients had better survival than non-Hispanic white patients. Over the past 20 years, disparities in survival actually decreased among Asian, Hispanic and non-Hispanic white individuals, but grew larger between African Americans and non-Hispanic white patients. In the most recent period (2018-2023), the gap widened by 50%.
Rachel Issaka, MD, MAS, the director of the Colorectal Cancer Screening Program at Fred Hutchinson Cancer Center and UW Medicine, in Seattle, who was not involved in the study, noted that molecular factors were not the most significant reason that outcomes varied by race. “Molecular characteristics accounted for 10% of survival disparities,” she said, “while neighborhood socioeconomic status and the site of primary tumor accounted for almost 50%.”
See “Disparities in Survival and Driver Mutations In CRC Shown in Large Database” (April 26, 2024)
