Mortality Risk From Early CRC Higher in Rural, Poor Areas

TOPLINE:

Patients with early-onset colorectal cancer (CRC) living in rural and impoverished areas face a significantly higher risk of dying from CRC.

METHODOLOGY:

• Previous research has shown that patients living in impoverished and rural areas have an increased risk of dying from CRC, but it is unclear if this trend applies to patients with early-onset CRC.
• Researchers analyzed 58,200 patients with early-onset CRC from the Surveillance, Epidemiology, and End Results Program between 2006 and 2015.
• Of these patients, 1346 (21%) lived in rural areas with persistent poverty. Persistent poverty was defined as having 20% or more of the population living below the poverty level for about 30 years, and rural locations were identified using specific US Department of Agriculture codes.
• The primary outcome was cancer-specific survival.

TAKEAWAY:

• The cancer-specific survival at 5 years was highest for patients who lived in neither poverty-stricken nor rural areas (72%) and the lowest for those who lived in impoverished areas irrespective of rural status (67%).
• Patients who lived in rural areas had a significantly higher risk of dying from CRC than those living in nonrural areas, with younger individuals facing the highest risk. More specifically, patients aged between 20 and 29 years had a 35% higher risk of dying from CRC, those aged between 30 and 39 years had a 26% higher risk, and those aged between 40 and 49 years had a 12% higher risk.
• Patients who lived in poverty and rural areas had a 29% increased risk of dying from CRC compared with those in nonrural areas — with the highest 51% greater risk for those aged between 30 and 39 years.

IN PRACTICE:

“Our results can be used to inform health system policies for ongoing investments in cancer diagnosis and treatment resources in rural or impoverished areas for younger CRC patients and their communities,” the authors wrote.

SOURCE:

The study, led by Meng-Han Tsai, PhD, Georgia Prevention Institute, Augusta University, Augusta, Georgia, was published online in JAMA Network Open.

LIMITATIONS:

Confounders, such as lifestyle factors, comorbidities, and structural barriers, could affect the findings.

DISCLOSURES:

This study was partially supported by a grant from the Georgia Cancer Center Paceline funding mechanism at Augusta University. The authors did not declare any conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.