Racial and Ethnic Disparities in Distant-Stage Presentation of Lung, Breast, and Colorectal Cancers, 2006-2021.

Authors

Oluwasegun Akinyemi, Keyline Moreno, Oladayo Oyebanji, Siobhan Nnorom, Mojisola Fasokun, Bolarinwa Akinwumi, Meghana Akula, Zarina Meer, Kakra Hughes, Edward Cornwell, Gal Levy

Published in

The American surgeon. Pages 31348261480812. Aug 23, 2026. Epub Aug 23, 2026.

Abstract

BackgroundRacial and ethnic disparities in stage at cancer diagnosis remain a major contributor to cancer-related mortality in the United States. Whether the magnitude of these disparities differs across cancers with distinct screening paradigms remains unclear.MethodsWe conducted a retrospective cohort study using the National Cancer Database (2006-2021) to examine racial and ethnic differences in distant-stage presentation among adults diagnosed with lung, breast, or colorectal cancer. Multivariable logistic regression models with robust standard errors were used to estimate adjusted odds ratios (ORs) for distant-stage disease. Interaction terms between race/ethnicity and cancer type were included to assess whether disparities differed across cancers. To facilitate cross-cancer comparisons, we also estimated adjusted predicted probabilities and absolute risk differences.ResultsAmong 3,386,771 patients, racial and ethnic disparities in distant-stage presentation varied substantially across cancer types. In lung cancer, compared with Non-Hispanic White (NHW) patients, the odds of distant-stage disease were modestly higher among Non-Hispanic Black (NHB) (OR, 1.02; 95% CI, 1.00-1.03), Hispanic (OR, 1.12; 95% CI, 1.10-1.14), and Non-Hispanic Other (NHO) patients (OR, 1.19; 95% CI, 1.16-1.22), corresponding to absolute increases of 0.5, 2.8, and 4.3 percentage points, respectively. In breast cancer, NHB patients experienced substantially higher odds of distant-stage presentation (OR, 1.61; 95% CI, 1.58-1.64), representing the largest disparity observed across all cancers. In colorectal cancer, NHB patients also had higher odds of distant-stage disease (OR, 1.14; 95% CI, 1.12-1.16), whereas Hispanic and NHO patients had lower odds and absolute probabilities compared with NHW patients.ConclusionsRacial and ethnic disparities in distant-stage presentation vary markedly across cancers. The largest inequities occur among Non-Hispanic Black patients with breast cancer despite the presence of long-standing population screening programs, suggesting that mechanisms beyond screening access-such as delays in diagnostic follow-up, barriers to care navigation, and structural inequities-contribute to persistent disparities in early cancer detection.

PMID:
42634432
Bibliographic data and abstract were imported from PubMed on 24 Aug 2026.

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