Metastasis patterns and racial disparities in gastrointestinal cancers: A SEER database population study 2010–2018.

Authors

Abdul Rahman Al Armashi

Abdul Rahman Al Armashi

St. Vincent Charity Medical Center, Cleveland, OH

Abdul Rahman Al Armashi , Faris Hammad , Dina Elantably , Kanchi Patell , Francisco Somoza-Cano , Anas Al Zubaidi , Keyvan Ravakhah , Akram Alkrekshi

Organizations

St. Vincent Charity Medical Center, Cleveland, OH, Metrohealth Medical Center Case Western Reserve University, Cleveland, OH, Baptist Health North Little Rock, North Little Rock, AR

Research Funding

No funding received

Background: Metastatic disease at the time of diagnosis of gastrointestinal (GI) malignancies is a strong predictor of poor outcomes. Differences in metastatic patterns among Caucasians (C) and African-Americans (AA) needs further elucidation. In this study, we analyzed the patterns of metastasis in C and AA in colorectal cancer (CRC), pancreatic cancer (PC), gastric cancer (GC), and liver cancer (LC). Methods: We identified patients with CRC, PC, GC, and LC from the Surveillance, Epidemiology, and End Results Program (SEER) database from 2010-2018. We obtained metastasis data to lungs, liver, bone, and brain at the time of diagnosis. We calculated the relative risk (RR), confidence interval (CI), and standard error with the use of SPSS software, 28.0 (IBM). Results: The most common metastasis site was the liver being highest at 39% in AA with PC. Brain metastasis was the least common. Significant racial disparities were noted. In CRC, AA had a 35-37% increased risk of metastasis to the liver, lung, or bone. AA had a higher risk of liver metastasis in PC and GC, whereas C had a higher risk of lung metastasis. Table 1 summarizes the data findings. Conclusions: This study illustrates the disparities of metastasis from GI cancers among AA and C. While a delay in screening, earlier onset of CRC in AA and socioeconomic factors may explain the disparities witnessed in CRC. However, these factors will fail to explain the difference in metastasis pattern in PC and GC in that AA had a higher risk of liver metastasis, and C had a higher risk of lung metastasis. Moreover, In GC, the brain metastasis rate in C was double that of AA. Further studies of possible biological and other risk factors are needed.

Cancer
Total number of patients by race
AA compared to C. Metastasis site prevalence (%). RR, 95% CI, and p-value
Colorectal
AA: 30,365


C: 184,141
Liver: AA 7,453 (24.5%) C 36.184 (19.7%) - RR 1.37 - CI [1.33 to 1.41] P < 0.001

Lung: AA 2,571 (8.5%) C 12,233 (6.6%) - RR 1.35 - CI [1.29 to 1.41] P < 0.001

Bone: AA 662 (2.2%) C 3,104 (1.7%) - RR 1.35 - CI [1.24 to 1.47] P < 0.001

Brain: AA 106 (0.4%) C 727 (0.4%) - RR 0.92 - CI [0.75 to 1.13] P = 0.41
Pancreas
AA: 13,577


C: 88,674
Liver: AA 5,282 (38.9%) C 31.624 (35.7%) - RR 1.12 - CI [1.08 to 1.16] P < 0.001

Lung: AA 1,276 (9.4%) C 8,743 (9.9%) - RR 0.92 - CI [0.87 to 0.98] P < 0.001

Bone: AA 474 (3.5%) C 3,020 (3.4%) - RR 1.00 - CI [0.91 to 1.11] P = 0.98

Brain: AA 66 (0.5%) C 339 (0.4%) - RR 1.24 - CI [0.95 to 1.62] P = 0.10
Gastric
AA: 8,505


C: 43,874
Liver: AA 1,431 (16.6%) C 6,503 (14.8%) - RR 1.14 - CI [1.07 to 1.21] P < 0.001

Lung: AA 365 (4.3%) C 2,155 (4.9%) - RR 0.86 - CI [0.77 to 0.96] P < 0.001

Bone: AA 274 (3.2%) C 1,971 (4.5%) - RR 0.70 - CI [0.62 to 0.80] P < 0.001

Brain: AA 31 (0.4%) C 313 (0.7%) - RR 0.51 - CI [0.35 to 0.73] P < 0.001
Liver
AA: 9,639


C: 50,225
Lung: AA 668 (6.9%) C 2,658 (6.1%) RR 1.30 - CI [1.19 to 1.42] P < 0.001

Bone: AA 477 (5.0%) C 2,009 (4.0%) - RR 1.22 - CI [1.10 to 1.35] P < 0.001

Brian: AA 38 (0.4%) C 172 (0.3%) - RR 1.12 - CI [0.79 to 1.60] P = 0.52

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Abstract Details

Meeting

2022 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gastrointestinal Cancer—Colorectal and Anal

Track

Gastrointestinal Cancer—Colorectal and Anal

Sub Track

Colorectal Cancer–Advanced Disease

Citation

J Clin Oncol 40, 2022 (suppl 16; abstr 3597)

DOI

10.1200/JCO.2022.40.16_suppl.3597

Abstract #

3597

Poster Bd #

391

Abstract Disclosures

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