Clinical outcome of Asian and non-Hispanic White patients with colorectal cancer in a NCI-designated cancer center serving a diverse catchment area.

Abstract

e15710 Background: Traditionally, research on the epidemiology and outcomes in minorities in the United States has primarily focused on differences between Non-Hispanic White (NHW) and Non-Hispanic Black (NHB) and Hispanic populations, with a lower emphasis on Asians, a gradually increasing demographic in the US. Recent literature suggests the rate of colorectal cancer (CRC) screening among Asian Americans remains low, despite an increasing rate of CRC diagnoses within this population. The differences between the disease courses of Asian and NHW patients are not well-characterized. In this study, we aimed to examine the diagnosis, treatment, and survival of Asian and NHW patients diagnosed with CRC. Methods: This was a retrospective, observational IRB-approved study of Asian and NHW patients treated for CRC at a single NCI-designated comprehensive cancer center. Descriptive variables were collected including demographics (age at diagnosis, gender, race/ethnicity), disease characteristics (stage at diagnosis, anatomical site of primary cancer, mutations), treatment (surgery, radiation, neo-adjuvant/adjuvant therapy, lines of treatment for advanced disease), and survival. The primary outcome was overall survival (OS) from time of stage IV diagnosis to death or last follow-up. Statistical analysis was performed using R software and GraphPad Prism, and Log-Rank tests were used to determine differences in OS between the two cohorts; patients were considered dead or censored if alive or status was unknown. Results: 122 patients were included in the study: Asian (n = 60) and NHW (n = 62). The overall survival data included 68% (n = 83) alive at last follow up, 28.7% (n = 35) deceased, and 3.3% (n = 4) unknown; this was consistent across both cohorts. Median age at initial diagnosis (years) of Asians was younger, but not significantly different [Asian 61, NHW 66; p = 0.279]; the same was observed for the median age (years) at stage IV diagnosis [Asian 60, NHW 68; p = 0.222]. Asian patients had a lower proportion of stage IV disease at initial diagnosis [Asian 30%, NHW 45%; p = 0.123]; however, NHW patients were significantly more likely to have stage IV CRC at any time during their disease course [Asian 37%, NHW 61%; p = 0.011]. There was no statistically significant difference in median OS (years) to death or last follow up from time of initial diagnosis [Asian 4.89, NHW 4.79; HR 0.88, p = 0.72], and for the primary outcome of median OS (years) from time of stage IV diagnosis to death or last follow up [Asian 3.03, NHW 2.87; HR 0.91, p = 0.934]. Conclusions: Asian and NHW patients have similar overall survival and ages at initial and stage IV diagnosis, but NHW are significantly more likely to have stage IV disease. Given their increasing presence in US society, more in-depth analysis of Asian populations with CRC is warranted to determine any disparities in screening, treatments, and outcomes.