Abstract A076: Racial disparities in disease-free and overall survival among colorectal cancer patients in the prospective ColoCare cohort
Authors: Jean-Baptiste Esther , Ilozumbo Mmadili , Rouhani Gazelle , Gomez Maria F. , Hogue Stephanie R. , Hardikar Sheetal , Gigic Biljana , Li Christopher I , Figueiredo Jane C , Toriola Adetunji T. , Ulrich Cornelia M , Shibata David , Siegel Erin M , Byrd Doratha A. 
Published: September 2024

Abstract
Background: Despite improvements in screening and treatment, Black and other underserved colorectal cancer survivors continue to experience poorer clinical outcomes. Multicenter prospective cohorts among large cancer centers in the United States (US) offer the unique opportunity to characterize potential multilevel determinants of disparate outcomes while accounting for known contributions of medical access and treatment. We investigated racial and ethnic disparities in disease-free survival (DFS) and overall survival in the ColoCare study, a prospective cohort study of newly diagnosed colorectal cancer patients across six US cancer centers. Method: The ColoCare study population (n=2,471) from six US sites included n=1,950 non-Hispanic White (NHW), n=238 non-Hispanic Black (NHB), and n=114 Hispanic patients. We estimated racial and ethnic differences in baseline patient characteristics using χ2. We investigated disparities in outcomes by estimating associations of race and ethnicity with DFS (among stage I-III) and overall mortality using Cox Proportional Hazards Models, adjusted for sex, stage at diagnosis, age, study center, and anatomic site. Results: The patients were primarily male (53%), had colon tumors (37.5%), with an average age at diagnosis of 58.6 years. Hispanic individuals were on average younger than their counterparts (P=.03), while NHB individuals were more likely to be overweight and obese (P&lt;.01). NHB individuals had statistically significantly poorer DFS than NHW individuals (HR=1.55, 95% CI=1.03-2.32; P=0.03). NHB individuals also had higher risk for overall mortality (HR=1.45, 95% CI=0.97-2.16; P=0.07), though these findings were not statistically significant. Overall, associations of Hispanic ethnicity with DFS and overall survival were close to null. Discussion: NHB individuals had poorer survivorship outcomes in our study despite all patients receiving care at designated comprehensive cancer centers. Our findings highlight the continued need to address disparities in survivorship using targeted, culturally sensitive intervention strategies. Future research efforts should identify actionable factors, such as adiposity, that may disproportionately impact health outcomes among minority colorectal cancer survivors.
Citation Format: Esther Jean-Baptiste, Mmadili Ilozumbo, Gazelle Rouhani, Maria F. Gomez, Stephanie R. Hogue, Sheetal Hardikar, Biljana Gigic, Christopher I Li, Jane C Figueiredo, Adetunji T. Toriola, Cornelia M Ulrich, David Shibata, Erin M Siegel, Doratha A. Byrd. Racial disparities in disease-free and overall survival among colorectal cancer patients in the prospective ColoCare cohort [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A076.