Abstract 1932: Evaluation of racial and ethnic psychotropic medication use among patients with colorectal cancer
Authors: Awunti MegCholack , Guo Yi , Rogers Sherise , Scarton Lisa , Wilkie Diana , Allen John 
Published: April 2023

Background: Colorectal cancer (CRC) is the 4th most common cancer type in the US. Following CRC treatment, about 37% of CRC survivors experience symptoms associated with anxiety and depression. Additionally, psychosocial distress is especially prevalent among CRC survivors with a stoma, and those reporting CRC-induced sexual dysfunction. Pharmacotherapy is one of the mainstay treatment options for psychological distress among patients with CRC. Research has shown that racial disparities are present with the use of supportive care medications in other cancer types. However, this has not been explored with the use of psychotropic medication for patients with CRC. The purpose of this research is to evaluate the presence of racial disparities in psychotropic medication use among patients with CRC.

Methods: Utilizing the National Cancer Institute Surveillance Epidemiology and End Results (NCI SEER)- Medicare linked database, our analysis included all patients with a CRC diagnosis and an active outpatient prescription claims for psychotropic medications from 2009-2018. Prescription claims were specific to patients diagnosed with CRC and stratified by self-identified race and ethnicity. Patients who were on psychotropic medications before CRC diagnosis, or unspecified race or ethnicity were excluded from the analysis. Psychotropic medications consisted of anxiolytics, antidepressants, and antipsychotic medications.

Results: 136,014 participants were included in the analysis. The racial and ethnic breakdown comprised of 81.56% White, 11.22% African American (AA), 2.66% Hispanic, 4.27% Asian/Pacific Islander (API), and 0.25% Native American (NA). Results are presented as unadjusted odds ratios (OR) and 95% confidence intervals (CI). Compared to White patients, AA (OR 0.53; 95% CI 0.50-0.56), API (OR 0.50; 95% CI 0.46-0.54), Hispanic (OR 0.64; 95% CI 0.58-0.71), and NA (OR 0.59; 95% CI 0.43-0.81) patients had lower utilization of anxiolytic medications. Regarding antidepressant use, AA (OR 0.55; 95% CI 0.53-0.57), API (OR 0.46; 95% CI 0.43-0.49), Hispanic (OR 0.73; 95% CI 0.68-0.79), and NA (OR 0.78; 95% CI 0.63-0.96) had lower utilization compared to White patients. Differences in antipsychotic medication use was observed with Asian/Pacific Islanders (OR 0.71; 95% CI 0.64-0.78) and Native Americans (OR 0.49; 95% CI 0.31-0.76) compared to White patients. No other racial differences in antipsychotic medications were identified.

Conclusion: The study showed that racial and ethnic disparities are present with the use of psychotropic medications among patients with CRC. Racial and ethnic minority patients had lower use for most of the drug classes evaluated. Further research is warranted to assess the potential barriers and facilitators of psychotropic medication use among patients belonging to historically minoritized racial and ethnic groups.

Citation Format: MegCholack Awunti, Yi Guo, Sherise Rogers, Lisa Scarton, Diana Wilkie, John Allen. Evaluation of racial and ethnic psychotropic medication use among patients with colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1932.