Disparities in Colorectal Cancer Incidence and Mortality Rates in Arkansas and Associated Risk Factors.

Abstract

Colorectal cancer (CRC) is a common malignancy in the United States, ranking as the third-leading cause of cancer-related deaths. Early detection is crucial for prognosis, treatment, and survival, yet disparities persist in CRC outcomes based on age, sex, race, and geography. In Arkansas, a significant proportion of CRC cases are diagnosed at a late stage, with notable disparities observed among different demographic groups. In this study, we utilized data from the Arkansas Central Cancer Registry (ACCR) and the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program to analyze CRC incidence and mortality rates in Arkansas and examine the associated disparities and risk factors. Data were stratified by sex, race, age, geographic area, and stage at diagnosis. Temporal trends and age-adjusted rates were computed using SEER*Stat software, and a bootstrapped logistic regression model was developed to identify predictors of late-stage CRC diagnosis. The analysis revealed that men had higher CRC mortality and incidence rates compared to women, with a mortality rate ratio (MRR) of 1.47 and an incidence rate ratio (IRR) of 1.35. Black individuals exhibited higher CRC mortality and incidence rates than their White counterparts (MRR, 1.46; IRR, 1.29). Late-stage CRC diagnosis was more common among men and individuals of Black race. Temporal trends showed a decline in CRC incidence from 2001 to 2011, followed by an increase from 2011 to 2019. Individuals aged 18-49 years experienced a significant rise in CRC incidence, highlighting an emerging concern for early-onset CRC. Geographic analysis indicated higher CRC incidence in rural vs urban areas. Overall, significant disparities in CRC outcomes were observed by sex, race, age, and geography. The increase in CRC incidence among younger adults underscores the need for targeted screening and early detection strategies. Geographic disparities highlight the necessity of improving health care access and screening services in rural areas.