Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations
ABSTRACT Purpose Recent work noted lower overall survival (OS) in American Indian/Alaskan Native (AI/AN) individuals diagnosed with colon cancer compared with non‐Hispanic White (NHW) individuals. Rectal cancer demographic profiles at diagnosis and survival outcomes have not been reported. We sought...
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| Format: | Article |
| Language: | English |
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Wiley
2025-04-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70892 |
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| author | Broc S. Kelley Cibele B. Carroll John M. Hampton Margaret R. Walker Syed Nabeel Zafar Dana Hayden Andrea Schiefelbein Roberto J. Vidri Bret Benally Thompson Noelle K. LoConte |
| author_facet | Broc S. Kelley Cibele B. Carroll John M. Hampton Margaret R. Walker Syed Nabeel Zafar Dana Hayden Andrea Schiefelbein Roberto J. Vidri Bret Benally Thompson Noelle K. LoConte |
| author_sort | Broc S. Kelley |
| collection | DOAJ |
| description | ABSTRACT Purpose Recent work noted lower overall survival (OS) in American Indian/Alaskan Native (AI/AN) individuals diagnosed with colon cancer compared with non‐Hispanic White (NHW) individuals. Rectal cancer demographic profiles at diagnosis and survival outcomes have not been reported. We sought to identify differences in rectal cancer diagnosis and outcomes between AI/AN and White populations. Methods White and AI/AN patients aged 18 or older, diagnosed between 2004 and 2020 with rectal adenocarcinoma were identified within the National Cancer Database (NCDB). Unadjusted and adjusted analyses were used to evaluate demographic and clinical standardized differences (stddiff) between AI/AN and White patients. Survival analyses of those diagnosed with locally advanced rectal cancer (Stage II/III) were performed using the Kaplan–Meier methods and multivariate Cox‐proportional hazards modeling. Results 176,341 eligible cases were identified: 0.6% were AI/AN (N = 992) and 99.4% White (N = 175,349). Compared to the White population, AI/AN patients were younger at diagnosis (mean age 59.9 vs. 64.5 years; stddiff = 0.36) and had more advanced stage disease (44.8% vs. 43.7%; stddiff = 0.15). A higher percentage of AI/AN resided in the areas of the lowest median income (35.5% vs. 15.1%; stddiff = 0.62) per zip code, rural (9.9% vs. 2.2%; stddiff = 0.65), and used Medicaid as their primary payor (14.3% vs. 6.2%; stddiff = 0.63). Adjusted analyses suggest the AI/AN group has an increased hazard of death compared with the White population (HR, 1.14; 95% CI, 1.05–1.25; p = 0.003). Conclusions AI/AN patients with rectal cancer have a younger age and a more advanced stage at diagnosis. AI/AN race is associated with lower OS compared to White patients in multivariable analyses. Future efforts should focus on increasing colorectal cancer screening and access to treatment for AI/AN populations in an attempt to improve survival outcomes. |
| format | Article |
| id | doaj-art-95c63c6e7d52488f8352b65a41c41202 |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-95c63c6e7d52488f8352b65a41c412022025-08-20T02:18:36ZengWileyCancer Medicine2045-76342025-04-01148n/an/a10.1002/cam4.70892Rectal Cancer Disparities Among the American Indian/Alaskan Native PopulationsBroc S. Kelley0Cibele B. Carroll1John M. Hampton2Margaret R. Walker3Syed Nabeel Zafar4Dana Hayden5Andrea Schiefelbein6Roberto J. Vidri7Bret Benally Thompson8Noelle K. LoConte9Department of Medicine, Division of Hematology, Oncology and Palliative Care University of Wisconsin School of Medicine and Public Health Madison Wisconsin USAUniversity of Wisconsin Carbone Cancer Center Madison Wisconsin USAUniversity of Wisconsin Carbone Cancer Center Madison Wisconsin USADepartment of Medicine, Division of Hematology, Oncology and Palliative Care University of Wisconsin School of Medicine and Public Health Madison Wisconsin USAUniversity of Wisconsin Carbone Cancer Center Madison Wisconsin USAUniversity of Wisconsin Carbone Cancer Center Madison Wisconsin USAMorgridge Institute for Research Madison Wisconsin USADivision of Surgical Oncology Department of Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USADepartment of Medicine, Division of Hematology, Oncology and Palliative Care University of Wisconsin School of Medicine and Public Health Madison Wisconsin USADepartment of Medicine, Division of Hematology, Oncology and Palliative Care University of Wisconsin School of Medicine and Public Health Madison Wisconsin USAABSTRACT Purpose Recent work noted lower overall survival (OS) in American Indian/Alaskan Native (AI/AN) individuals diagnosed with colon cancer compared with non‐Hispanic White (NHW) individuals. Rectal cancer demographic profiles at diagnosis and survival outcomes have not been reported. We sought to identify differences in rectal cancer diagnosis and outcomes between AI/AN and White populations. Methods White and AI/AN patients aged 18 or older, diagnosed between 2004 and 2020 with rectal adenocarcinoma were identified within the National Cancer Database (NCDB). Unadjusted and adjusted analyses were used to evaluate demographic and clinical standardized differences (stddiff) between AI/AN and White patients. Survival analyses of those diagnosed with locally advanced rectal cancer (Stage II/III) were performed using the Kaplan–Meier methods and multivariate Cox‐proportional hazards modeling. Results 176,341 eligible cases were identified: 0.6% were AI/AN (N = 992) and 99.4% White (N = 175,349). Compared to the White population, AI/AN patients were younger at diagnosis (mean age 59.9 vs. 64.5 years; stddiff = 0.36) and had more advanced stage disease (44.8% vs. 43.7%; stddiff = 0.15). A higher percentage of AI/AN resided in the areas of the lowest median income (35.5% vs. 15.1%; stddiff = 0.62) per zip code, rural (9.9% vs. 2.2%; stddiff = 0.65), and used Medicaid as their primary payor (14.3% vs. 6.2%; stddiff = 0.63). Adjusted analyses suggest the AI/AN group has an increased hazard of death compared with the White population (HR, 1.14; 95% CI, 1.05–1.25; p = 0.003). Conclusions AI/AN patients with rectal cancer have a younger age and a more advanced stage at diagnosis. AI/AN race is associated with lower OS compared to White patients in multivariable analyses. Future efforts should focus on increasing colorectal cancer screening and access to treatment for AI/AN populations in an attempt to improve survival outcomes.https://doi.org/10.1002/cam4.70892American Indian or Alaska Nativecolorectal cancerhealth status disparitiesminority healthrectal cancer |
| spellingShingle | Broc S. Kelley Cibele B. Carroll John M. Hampton Margaret R. Walker Syed Nabeel Zafar Dana Hayden Andrea Schiefelbein Roberto J. Vidri Bret Benally Thompson Noelle K. LoConte Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations Cancer Medicine American Indian or Alaska Native colorectal cancer health status disparities minority health rectal cancer |
| title | Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations |
| title_full | Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations |
| title_fullStr | Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations |
| title_full_unstemmed | Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations |
| title_short | Rectal Cancer Disparities Among the American Indian/Alaskan Native Populations |
| title_sort | rectal cancer disparities among the american indian alaskan native populations |
| topic | American Indian or Alaska Native colorectal cancer health status disparities minority health rectal cancer |
| url | https://doi.org/10.1002/cam4.70892 |
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