Disproportionate morbidity and mortality in African American and Asian patients from colorectal cancer: A nationwide analysis.

Abstract

3628 Background: Published literature points towards the disproportionate prevalence of colorectal cancer (CRC) in ethnic groups. Racial minorities are also prone to higher mortality due to inequalities in access to healthcare. Therefore, we examined the disparities in hospital-related outcomes among racial groups from CRC. Methods: We investigated the National Inpatient Sample 2019 employing International Classification of Diseases-10 (ICD-10) codes to include adult patients with CRC. We compared various outcomes stratified by racial groups with White as the reference group. Analyses were performed using STATA (v 14.2), considering 2 sided P< 0.05 as statistically significant. Proportions were compared using Fisher exact test and continuous variables using Student’s t-test. Confounding variables were adjusted using multivariate logistic and linear regression analyses and included: gender, Charlson Comorbidity Index, median household income for patients’ zip codes, hospital location/region/bedside, and insurance status. Results: Out of 732,492 included patients, 72.77% White, 13.66% African American (AA), 9.91% Hispanics, and 3.65% Asians were in the cohort. AA and Asians had higher mortality odds than White, while Hispanics had mortality similar to White. AA had a lower mean length of stay by 0.74 days than White. All racial groups incurred higher mean total charges compared to White. AA and Hispanics had lower odds of undergoing colectomy. Overall, all racial groups had high morbidity compared to White. Among subgroups, the odds of morbidity markers (sepsis, lower GI bleed, and acute renal failure) were higher in AA and Asians than Hispanics. Post-op adhesions and DVT/PE were not significantly different among racial groups. Conclusions: AA and Asians disproportionately suffer from higher mortality from colorectal cancer than Hispanics and White. Lower colectomy rates (a definitive CRC treatment) in AA and higher in-hospital complication burden in Asians are possible explanations; however, further research needs to establish if race-specific genomics are also responsible for disparities. [Table: see text]