The impact of race and socioeconomic status on stage IV colorectal cancer survival

Abstract

BackgroundThe aims of this study were to determine the impact of race and socioeconomics on survival in patients with stage IV colorectal cancer. MethodsA prospective database of stage IV colorectal cancer patients treated at a multi-hospital health system from 2015 to 2019 was retrospectively analyzed. Univariate and multivariate survival analysis using log-rank Mantel-Cox test and Cox proportional hazard model were performed to determine the impact of race, socioeconomic factors, presentation, and treatment on overall survival. Results4012 patients were diagnosed with colorectal cancer, of which 803 patients were stage IV. There were 677 (84.3%) White, and 108 (13.4%) Black patients. Black patients have worse 5-year overall survival than white patients (HR 1.43 (1.09–1.87)). Patients who received chemotherapy had significantly better survival than patients who did not receive chemotherapy (HR 0.58 (0.47–0.71)). Black patients have significantly lower rates of receiving chemotherapy as compared to white patients (61.1% vs 75.37%, p = 0.0018). ConclusionPatients with Stage IV colorectal cancer have worse survival if they are black, older age, and did not receive chemotherapy.