P2351 - Colorectal Cancer (CRC) in a Socially Disadvantaged Inner-City Population: Comparison With National Data

Osayande Osagiede, MD, MPH¹, Maria Gabriela Rubianes Guerrero, MD¹, Michail Kladas, MD², Donald P. Kotler, MD^1
1Jacobi Medical Center, Bronx, NY; ²North Central Bronx Hospital, Bronx, NY

Introduction: Despite the well-described benefits of CRC screening in reducing incidence and mortality, studies suggest that disparities exist in socially disadvantaged populations. Our aim was to describe the demographic and clinical features of CRC patients seen in our patient population, as well as similarities and differences from national data.

Methods: Observational descriptive study of CRC patients at a public hospital in New York City within 5 years. Patients were identified using ICD-9 and ICD-10 codes. De-identified data were collected on demographics, co-morbidities, prior examinations, signs or symptoms, indications (diagnostic vs screening), and cancer stage. Findings were compared to the Surveillance, Epidemiology, and End Results (SEER) database (2014-2018).

Results: 292 patients were identified. Figure 1 shows the percent of new cases by age, clinical stage, and sex in our group and in SEER. Most of our patients presented with symptoms (79.5%) and had no prior colonoscopy (83.3%), and were detected by diagnostic (78.8%) procedures.

Discussion: Similar to national data, CRC occurrence was highest in Blacks and localized stages in this study. In contrast, a higher proportion of CRC patients in this population were female and of a younger age (ages 45-75) compared to national data. Notably, most patients presented with symptoms and displayed low utilization of routine colonoscopy screening, which may suggest that socially disadvantaged patient populations such as this study may have more obstacles to effective screening, related to both patient and systemic factors. This speculated disparity in routine screening may also explain the high proportion of diagnostic procedures performed.



Reference:

SEER Database (November 2020). Colon and Rectum SEER 5-Year Age-Adjusted Incidence Rates, 2014-2018. Last updated April 23, 2021.

https://seer.cancer.gov/explorer/application.html?site=20&data_type=1&graph_type=10&compareBy=sex&chk_sex_3=3&chk_sex_2=2&series=9&race=1&age_range=1&stage=101&advopt_precision=1&advopt_show_ci=on Last updated April 23, 2021.




Figure: A- Current study, age at diagnosis
B- SEER database, age at diagnosis
C- Current study, stage at diagnosis
D- SEER database, stage at diagnosis
E- Current study, sex distribution
F- SEER database, sex distribution
* SEER data for stage and sex are expressed as incidence rate per 100,000 population.
* Stages categorized as localized (AJCC stages 0-II), regional (stage III), distant (stage IV), and unstaged.


Disclosures:
Osayande Osagiede indicated no relevant financial relationships.
Maria Gabriela Rubianes Guerrero indicated no relevant financial relationships.
Michail Kladas indicated no relevant financial relationships.
Donald Kotler indicated no relevant financial relationships.


Osayande Osagiede, MD, MPH¹, Maria Gabriela Rubianes Guerrero, MD¹, Michail Kladas, MD², Donald P. Kotler, MD¹. P2351 - Colorectal Cancer (CRC) in a Socially Disadvantaged Inner-City Population: Comparison With National Data, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.