Abstract 3633: Exploring racial and ethnic disparities in supportive medication use for nonmetastatic colorectal cancer: a SEER-Medicare database analysis
Authors: Olga Trejos Kweyete, Yi Guo, Sherise Rogers, Lisa Scarton, David Deremer, Diana Wilkie, John Allen
Journal: Cancer Research (2025)

Abstract Background: Colorectal cancer (CRC) is a devastating disease with CRC patients experiencing physical disease and treatment-related symptoms that seriously impact the quality of life and psychological health. These symptoms often require supportive care medications (SCM) to manage and improve health-related quality of life throughout the illness trajectory. This study explores racial and ethnic differences in using SCMs in nonmetastatic CRC, aiming to uncover barriers and promote equitable care. Methods: Data from the SEER-Medicare-linked database (2005-2017) were analyzed for metastatic CRC patients who died during this period and had over a year of Medicare enrollment. Logistic regression assessed the relationship between SCM use and race, controlling for variables like sex, age, marital status, education, income, residence, and Charlson Comorbidity Index, with non-Hispanic White patients as the reference group. Results are presented as the adjusted Odds Ratio and 95% Confidence Interval. Results: After applying the inclusion/exclusion criteria, 81784 patients were included in the final analysis (White:72.6%, Black: 10.0%, Hispanic: 7.9%, Asian/Pacific Islander: 4.2%). Racial and ethnic disparities in the use of multiple SCM drug classes were identified. The results are summarized in Table 1. Black/African American n=8214 Hispanic n=6491 Asian n=3392 Medications for neurological symptoms aOR ( 95% CI) aOR ( 95% CI) aOR ( 95% CI) Anti-emetics 0.88 (0.83, 0.93) 1.13 (1.07, 1.2) 1.05 (1.05, 1.23) Anti-epileptics 1.22 (1.11, 1.33) 0.97 (0.87, 1.08) 0.78 (0.67, 0.91) Headache aids 0.8 (0.73, 0.89) 0.97 (0.88, 1.07) 1.04 (0.90, 1.19) Steroids 0.73 (0.69, 0.77) 0.92 (0.86, 0.97) 1.00 (0.92, 1.09) Cognitive aids 1.18 (1.1, 1.28) 1.13 (1.04, 1.23) 0.97 (0.86, 1.09) Other Muscle relaxants 0.97 (0.87, 1.08) 0.78 (0.67, 0.89) 0.70 (0.57, 0.86) Sleep aids 0.74 (0.67, 0.79) 0.95 (0.89, 1.01) 0.88 (0.81, 0.96) Appetite stimulants 0.99 (0.94, 1.04) 1.07 (1.01, 1.13) 1.30 (1.21, 1.40) Conclusion: Black patients tended to have lower odds of supportive care medication use across several SCM classes, particularly anti-emetics, headache aids, steroids, and sleep aids, while showing higher use of anti-epileptics and cognitive aids than White patients. Hispanic patients showed higher odds than White patients of using anti-emetics, cognitive aids, and appetite stimulants but had lower odds for muscle relaxants and steroids. Asian patients displayed higher odds for using anti-emetics and appetite stimulants but lower odds for using anti-epileptics, muscle relaxants, and sleep aids. Citation Format: Olga Trejos Kweyete, Yi Guo, Sherise Rogers, Lisa Scarton, David Deremer, Diana Wilkie, John Allen. Exploring racial and ethnic disparities in supportive medication use for nonmetastatic colorectal cancer: a SEER-Medicare database analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 3633.