Racial and socioeconomic disparities in colorectal cancer incidence following bariatric surgery: A retrospective analysis (2009–2022).

Abstract

e15634 Background: Obesity is a major modifiable risk factor for cancer and is associated with increased colorectal cancer (CRC) incidence and mortality. Bariatric surgery, an effective intervention for sustained weight loss, has been shown to reduce CRC risk. However, racial and socioeconomic disparities persist, particularly in Hispanic populations, who experience shorter intervals to CRC onset post-surgery. Socioeconomic factors, such as income and education, appear to influence CRC outcomes disproportionately. This study aimed to evaluate CRC incidence, timing, and associated risk factors in a racially and socioeconomically diverse cohort undergoing bariatric surgery over a 13-year period, with the goal of identifying disparities and opportunities for targeted interventions. Methods: A retrospective cohort study was conducted on 960 patients who underwent bariatric surgery at a single institution (2009–2022). Clinical and demographic data, including comorbidities, insurance, surgical details, colonoscopy findings, and pathology reports, were collected using ICD and CPT codes. Patients developing CRC post-surgery were stratified by sex, race, and tumor location. Propensity score matching ensured baseline comparability, while Kaplan-Meier analysis assessed CRC onset timing. Odds ratios were calculated to identify independent factors influencing CRC development. Results: Among the 960 patients, 119 (12%) developed CRC, with an average diagnosis time of 47.7 ± 23.3 months post-surgery. The average age in the study group was 58.34±7.39, with 82% being female. The cohort was racially diverse: 41% African American, 20% White, 13.4% Asian, and 30% Hispanic. Hispanic patients exhibited the shortest interval to CRC onset (log-rank Mantel-Cox: 16.210, p = 0.05). The average age of CRC patients was 58.34 ± 7.39 years, and 82% were female. Socioeconomic factors, particularly lower income (OR: 1.15, p < 0.05) and education levels (OR: 2.23, p = 0.025), were significant CRC risk factors in Hispanic patients. Conclusions: This study underscores the significant racial and socioeconomic disparities in CRC outcomes post-bariatric surgery, with Hispanic patients experiencing the shortest onset intervals and pronounced effects of socioeconomic factors. These findings highlight the urgent need for targeted screening, tailored interventions, and enhanced follow-ups in high-risk populations to mitigate disparities and improve CRC outcomes. Future research should focus on understanding and addressing the underlying drivers of these disparities.