Immigrant Health and Early-Onset Colorectal Cancer Disparities: Results From the Spanish Early-Onset Colorectal Cancer Consortium
Authors: Perea José , Martí-Gallostra Marc , García-Rodríguez Ariadna , Vidal-Tocino Rosario , Alcázar José A. , López-Rojo Irene , Encinas García Sara , Hurtado Elena , Jiménez Luis M. , Álvaro Edurne , Burdaspal Ana , Sanz Gonzalo , Sanz López Rodrigo , Jiménez Toscano Marta , Iglesias Comas Mar , Jiménez Fernando , Cavero Adriana , Balaguer Francesc , Daca María , Ballestero Araceli , Die Trill Javier , Melone Sirio , Rueda José A. , Hernández-Villafranca Sergio , García-Olmo Damián , Pastor Carlos , Alvarellos Alicia , Brandáriz Lorena , Viyuela Cristina , Vivas Alfredo , Muñoz Paula , González-Sarmiento Rogelio , Holowatyj Andreana N. ,   Spanish EOCRC Consortium (SECOC), Altamarina Edgardo Celi , Elena García  , Pardo Ma del Mar , López Laura Vega , Escanciano Manuel , Portugal Vicente , Domenech María Arriba , Gómez Isabel Peligros , Ortúzar Jaime Zorrilla , Daca María , Ocaña Teresa , Castillo Joaquín , Cuatrecasas Miriam , Carballal Sabela , Kumari Hardeep , Moreira Leticia , Moreno Lorena , Pellisé María , Sánchez Ariadna , Molina Ana Ramírez de , Colmenarejo Gonzalo , Espinosa-Salinas Isabel , Fernández Lara P. , Cedrón Marta Gómez de , Corchete Luis , García Juan L. , García-Vallés Paula , Herrero Ana B. , Pérez Jésica , Fuenmayor Maria Luisa de , Alonso Oscar , Encinas Sara , Teijo Ana , Arredondo Jorge , Matos Ignacio , Rodríguez Javier , Candela Alba Fernández , Cebrián José Ma Fernández , Jiménez Juan Ocaña , Dziakova Jana , Marín Sara Picazo , Solís María Suárez , Antona Francisco Blanco , Malats Núria , Estudillo Lidia , Kraft Miquel , Marinello Franco , Valverde Ignacio 
Published: November 2024

PURPOSE
To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin.

PATIENTS AND METHODS
We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison.

RESULTS

Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%;
P
= .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%;
P
< .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1
v
42.5), more frequently male (77.8
v
47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [
P
= .01]), and had a worse prognosis regarding recurrence rates (29.4%
v
6.3%).

CONCLUSION
Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.