Abstract 1838: Survival and gender disparities in Puerto Rican Hispanics with colorectal cancer: A five-year analysis

Abstract

Abstract BACKGROUND: In Puerto Rico (PR), colorectal cancer (CRC) represents the second most common cause of cancer in men and women. Incidence and mortality of CRC are increasing in Puerto Rican Hispanics. Screening rates for CRC are lower in US and PR-Hispanics, which may result in advanced disease at diagnosis and poor outcomes. There is very limited data on survivorship among PR-Hispanic CRC patients. Hence, we examined the 5-year overall and stage-specific CRC survival for Puerto Rican Hispanics. METHODS: All malignant CRC cases were obtained from the PR Central Cancer Registry (PRCCR), a population based cancer registry. CRC cases diagnosed from the years 2001 to 2003 were selected for the survival analysis. One-, three- and five-year relative survival were calculated using the incidence case file database of PR and estimated using the Kaplan Meier method. Relative survival, defined as observed survival in the cohort divided by expected survival in the cohort, adjusted for the expected mortality from other causes of death were calculated. The 5-year survival functions were compared among demographics variables (sex, age group and stage at diagnosis) via Z-tests. CRC reported without stage and a sample of staged cases were examined and reviewed manually to ensure accuracy in the staging variable. Analyses were performed using SEER Stat 6.6.2. RESULTS: Overall CRC incidence and mortality rates were 38.9 and 15.3 per 100,000 population, respectively. A total of 3,251 individuals diagnosed with CRC during the 2001-2003 periods with complete survival data were evaluated. At diagnosis CRC was staged as localized (30.1%), regional (46.2%), and distant (11.9%). Overall CRC relative survival decreased within the 5-year observational period, with rates of 76.6%, 53.5%, and 36.6% for 1-, 3-, and 5-years, respectively. The 5-year relative survival was statistically significant better for women (40.4%) than for men (30.3%) (p=0.0023). Five-year stage-specific relative survival for localized, regional and distant CRC was 58.5%, 35.9% and 8.1%, respectively. This trend was observed for both genders, although men with localized (54.3% vs. 63.1%) and regional (33.7% vs. 38.2%) CRC had poorer 5-year survivorship compared to women. CONCLUSIONS: Our study demonstrated low overall and stage-specific CRC 5-year relative survival for PR Hispanics, compared to previously reported data for US-Hispanics, non-Hispanics Whites and non-Hispanic Blacks. PR Hispanics with localized/regional CRC had lower 5-year relative survival rates than that observed in other racial and ethnic groups. Men with CRC had worse 5-year overall and stage-specific relative survival compared to women. The observed survival and gender disparities in PR Hispanics with CRC warrant further studies evaluating the interplay of molecular, behavioral and/or environmental risk factors affecting this minority population. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1838. doi:10.1158/1538-7445.AM2011-1838