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Non-White Race and Low Socioeconomic Status Associated With Longer Wait for Treatment After Colorectal Cancer Diagnosis

Douglas K. Rex, MD, MASGE, reviewing Bui A, et al. Gastroenterology 2020 Oct 12.

The time between diagnosis of colorectal cancer (CRC) and initiation of treatment is associated with mortality. In this study of 330,988 CRC cases in the U.S. between 2000 and 2016, the diagnosis-to-treatment interval was divided into short (≤1 month) and prolonged (>1 month). Factors independently associated with earlier treatment included female sex, younger age, localized disease versus regional or distant metastases, and rural location.

Compared to non-Hispanic White patients, non-Hispanic Black, non-Hispanic Asian/Pacific Islander (NHAPI), and non-Hispanic American Indian/Alaskan Native (NHAIAN) patients all had increased odds of prolonged time to treatment. Among Black patients, higher rates of delayed treatment were seen across all socioeconomic groups. For Hispanic, NHAPI, and NHAIAN patients, there were delays or trends for delays across all socioeconomic groups, but the effects were greatest among those with low socioeconomic status.

Douglas K. Rex, MD, FASGE

COMMENT

We already know there are racially-based differences in screening rates and CRC mortality in the U.S. These data indicate that some increased mortality in non-White patients with CRC may be related to delays in treatment. These data are a call for all of us to be aware of the need to expedite CRC treatment regardless of race or socioeconomic status. Efforts to eliminate discriminatory bias and structural racism that contribute to delays in treatment are essential.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Bui A, Yang L, Myint A, May FP. Race, ethnicity, and socioeconomic status are associated with prolonged time to treatment after a diagnosis of colorectal cancer: a large population-based study. Gastroenterology 2020 Oct 12. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2020.10.010)

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