Race and Socioeconomic Status Impact Survival from Early and Late-Onset Colorectal Cancer.

Authors

Kristen Purrington, Mei-Chin Hsieh, Siddhi Patil, Batsirai Mabvakure, Jaeil Ahn, Rui Zhang, Julie J Ruterbusch, Rashmi Samdani, Grace Lee, Angela Wenzlaff, Sophia Latif, Chiranjeev Dash, Maureen Sartor, Ann G Schwartz, Elena M Stoffel, Laura S Rozek

Published in

medRxiv : the preprint server for health sciences. Jun 29, 2026. Epub Jun 29, 2026.

Abstract

Colorectal cancer (CRC) disproportionately affects non-Hispanic Black (NHB) Americans compared to Non-Hispanic White (NHW), with more cases arising before age 50. Racial disparities in outcomes reflect complex interactions among healthcare access, socioeconomic factors, and structural racism, yet analyses linking individual-level data for these factors to survival remain limited.
We examined overall and CRC-specific survival among NHB and NHW patients diagnosed between 2013 and 2022 enrolled in the Disparities and Cancer Epidemiology (DANCE) cohort, a population-based study of CRC in metropolitan Detroit and Louisiana. Multivariable Cox regression and competing-risks models were used to assess the roles of race, age of onset, neighborhood deprivation, and stage on survival outcomes.
Among 1,019 CRC cases (57% NHB, 43% NHW), NHB patients were more likely to reside in high-deprivation neighborhoods, report lower household incomes, and present with right-sided tumors, though stage at diagnosis did not differ by race. In multivariable analysis, stage was the strongest predictor of survival, while neighborhood deprivation (per 10-unit ADI increase: HR = 1.14) was independently associated with worse survival; NHB race was not significantly associated with survival after adjustment. Younger age at diagnosis was associated with a survival advantage in regional-stage disease but paradoxically with worse survival in distant-stage disease, and higher deprivation predicted worse survival in both local and distant but not regional stage.
Our study shows that socioeconomic factors, as measured by ADI and household income, accounts for some, but not all, of the disparities in survival between NHB and NHW CRC cases.

PMID:
42428080
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.