Abstract
1525 Background: Impact of race on prognosis of colon cancer (CCa) is controversial and the potential reasons for that are not clearly understood. We analyzed data from Cancer Information Reference File (CIRF) database to study factors that might affect survival in African American (AA) and White (W) patients (pts) with CCa. Methods: Of 37,394 pts diagnosed with CCa from 1993-2008, complete data (age, sex, disease status, tumor characteristics, treatment and overall survival) were available for 35,310 pts (32,614 W and 2,696 AA). Results: Median age at diagnosis was 73 years (yrs) for W vs 66 yrs for AA pts (p < 0.0001). Total of 27% of W vs. 14% of AA pts (p < 0.0001) were ≥ 80 yrs of age at time of diagnosis while 7% of W vs. 12% of AA pts (p < 0.0001) were <50 yrs of age at time of diagnosis. Stage IV, high-grade tumor and right sided tumor were present in 18% vs. 14% (p < 0.0001), 21% vs. 15% (p < 0.0001), 52% vs. 51% of W and AA pts, respectively. Less than 12 lymph nodes were retrieved at surgery in 44% of W vs. 41% of AA pts (p - 0.009). Overall, 34% of W vs. 37% of AA pts received chemotherapy. Median overall survival for pts < 70 yrs of age was 109 months (mnths) vs. 91 mnths (p - 0.0008) and for pts ≥ 70 yrs was 48 mnths vs. 40 mnths (p - 0.0005) for W and AA pts, respectively. On multivariate cox regression analysis, race was an independent prognostic factor for survival, with AA having a 20% higher risk of death compared to W pts in both < 70 yrs (HR - 0.8, p < 0.0001) and ≥ 70 yrs old pts (HR - 0.8, p < 0.0001). Conclusions: AA pts present at a much younger age and advanced stage of CCa at the time of diagnosis. Despite lower grade, optimal surgery and similar rates of chemotherapy, all AA pts (younger and older) with CCa have a worse survival than W pts. This could be due to biological differences of tumors yet to be identified or other comorbidities in AA pts.Older pts in both groups have significantly poor survival as compared to younger pts. No significant financial relationships to disclose.
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