Age-related disparities in survival following colorectal cancer diagnosis in an underserved community in Georgia: A retrospective cohort analysis.
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INTRODUCTION: Limited studies have examined disparities regarding age at diagnosis and 5-year overall survival (OS) following colorectal cancer (CRC) diagnosis within medically underserved areas in Georgia. The study aim was to examine this association and determine key factors of 5-year survival within four age groups in Augusta-Richmond County, Georgia. MATERIALS AND METHODS: We conducted a retrospective cohort analysis using 2012-2022 data from an institutional cancer registry linked with medical records and billing data from a single cancer center in Georgia. Multivariable Cox proportional hazard regression models were used. RESULTS: Among 839 patients with CRC, 5-year survival rates were lowest among patients aged 70+ years (54.9 % vs. 63.4 % for 60-69 years, 67.2 % for 50-59 years, and 67.4 % for 18-49 years) (p < 0.001). Patients with CRC with a late stage at diagnosis were associated with increased risk of death by 2 to 7 times (18-49 years: HR, 5.45; 95 % CI, 2.28-10.55; 50-59 years: HR, 6.72; 95 % CI, 4.08-11.06; 60-69 years: HR, 5.98; 95 % CI, 3.92-9.10; 70+ years: HR, 2.21; 95 % CI, 1.41-3.46). Further, 50-59-year-old former smokers had an increased risk of death (HR, 2.16; 95 % CI, 1.11-4.20). Patients aged 60-69 years and living in persistent poverty areas also had an increased risk of death (HR, 1.85; 95 % CI, 1.20-2.85). DISCUSSION: Advanced diagnoses were associated with a greater risk of mortality regardless of age group. Former smokers and those living in persistent poverty areas were also linked to increased mortality for 50-59 and 60-69 age groups, respectively. Improving equitable access to screening facilities/ cancer treatment resources and promoting healthy lifestyles are critical.