Relative survival at 1, 3, 5, and 10 years by race/ethnicity in colorectal cancer: A SEER-based analysis.

Abstract

50 Background: Colorectal cancer remains a leading cause of cancer death in the United States. Population-based estimates of short, intermediate, and long-term relative survival (RS) by race/ethnicity can reveal inequities and guide actionable improvements in screening, diagnostics, and biomarker-driven therapy. Methods: We performed a retrospective, population-based analysis of CRC cases from the Surveillance, Epidemiology, and End Results (SEER) program (colon and rectal cancers, both sexes, all ages; appendix excluded). Primary outcomes were 1-, 3-, 5-, and 10-year RS overall and by stage, estimated using standard life-table methods. Race/ethnicity groups were Hispanic, non-Hispanic White (NHW), and non-Hispanic Black (NHB). In planned stratified analyses, we assess RS by stage (localized, regional, distant) and tumor subsite (proximal/distal colon, rectum). Results: Among patients with CRC, RS at 1/3/5/10 years was 84.7/70.9/63.5/55.7% for Hispanic, 82.7/71.1/65.2/58.9% for NHW, and 80.6/65.5/58.5/52.1% for NHB. Early survival (1 year) was high across groups, but gaps widened at 3–10 years, with NHB consistently lowest and Hispanic intermediate between NHW and NHB. Stage-specific contrasts were directionally similar; for distant-stage disease overall, 3-year RS was ~24%. These patterns suggest contribution from unequal access to timely diagnosis, universal tumor MMR testing, and guideline-concordant, biomarker-directed therapy. Conclusions: Meaningful racial/ethnic gaps in intermediate and long-term RS persist in U.S. CRC despite relatively high early survival. Findings support system-level actions: culturally tailored screening (FIT/colonoscopy), rapid diagnostic evaluation, universal tumor MMR with reflex germline testing when indicated, and equitable delivery of guideline-concordant, biomarker-directed treatments (e.g., anti-EGFR/anti-VEGF in appropriate molecular contexts; immune checkpoint inhibitors for MSI-H). Future work linking treatment receipt to RS will help quantify how modern regimens influence disparities. Study summary and key outcomes. Item Value Source & design SEER, population-based retrospective analysis Time points 1-, 3-, 5-, and 10-year relative survival 1-year RS Hispanic 84.7% (95% CI 84.5–84.9) | NHW 82.7% (82.6–82.8) | NHB 80.6% (80.3–80.8) 3-year RS Hispanic 70.9% (70.7–71.2) | NHW 71.1% (70.9–71.2) | NHB 65.5% (65.2–65.8) 5-year RS Hispanic 63.5% (63.2–63.8) | NHW 65.2% (65.1–65.4) | NHB 58.5% (58.2–58.8) 10-year RS Hispanic 55.7% (55.3–56.1) | NHW 58.9% (58.7–59.1) | NHB 52.1% (51.6–52.5)