School of Medicine Publications and Presentations
Document Type
Article
Publication Date
4-2025
Abstract
Introduction: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the U.S., with disparities in incidence, survival, and age at diagnosis across racial, ethnic, and socioeconomic groups. The rising incidence of early-onset CRC (< 50 years) has amplified concerns regarding access to care, screening disparities, and outcomes, particularly among minorities. This study examines the impact of race, ethnicity, socioeconomic status (SES), and sex on CRC survival and age at diagnosis in Texas from 1995 to 2016.
Methods: This retrospective cohort study utilized Texas Cancer Registry (TCR) data, including 235,076 CRC cases diagnosed between 1995 and 2016. Kaplan-Meier analysis and log-rank tests assessed 10-year survival by race and ethnicity and time period (1995-2005 vs. 2006-2016). Kruskal-Wallis tests with Bonferroni correction were used to compare survival years between racial/ethnic groups within each period. Age at diagnosis was analyzed by race and ethnicity, and SES using Welch ANOVA and Games-Howell post hoc testing. Welch’s t-tests compared intra-race changes across decades. Sex-based differences in diagnosis age were assessed using Mann-Whitney U tests.
Results: Significant racial, ethnic, and socioeconomic disparities were observed in CRC outcomes. Black: Non-Hispanic and Black: Hispanic patients exhibited some of the lowest median survival times, with minimal overall improvement between the two time periods. Although Black: Hispanic patients exhibited the lowest median survival, the difference was not statistically significant in the 2006-2016 cohort (p = 0.12). Hispanic and Black patients were diagnosed at younger ages compared to White: Non-Hispanic patients. Lower SES was associated with younger age at diagnosis and worse survival. Male patients were consistently diagnosed earlier than female patients across both decades. Despite some improvement in survival for certain groups, disparities persisted, particularly for Black: Non-Hispanic and Black: Hispanic patients.
Conclusion: Disparities in CRC survival and diagnosis age persist across racial, ethnic, SES, and sex lines in Texas. These findings underscore the need for tailored screening efforts, improved healthcare access, and targeted interventions for high-risk populations. Persistent sex-based differences highlight a need for further research into biological and systemic factors. Addressing social determinants of health may help reduce these disparities.
Recommended Citation
Torres, T., Arellano Villanueva, E., Alsabawi, Y., Fofana, D., & Tripathi, M. K. (2025). Unraveling Early Onset Disparities and Determinants: An Analysis of Colorectal Cancer Outcomes and Trends in Texas. Cureus, 17(4), e83124. https://doi.org/10.7759/cureus.83124
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
Cureus
DOI
10.7759/cureus.83124
Academic Level
faculty
Comments
Copyright © 2025, Torres et al.
This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.