Ethnic and socioeconomic disparities in cancer-free and all-cause survival in cholangiocarcinoma patients under 60: A population-based study.

527 Background: Cholangiocarcinoma in individuals under 60 years of age is rare, and survival outcomes can vary based on ethnic and socioeconomic factors. While previous studies have examined these disparities in other cancers, little is known about their impact on cancer-free and all-cause survival in younger cholangiocarcinoma patients. This study investigates the role of race and income in survival outcomes for this population. Methods: Data for individuals under 60 diagnosed with cholangiocarcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) 22 registry. Kaplan-Meier curves were constructed to assess overall and cancer-free survival. Median survival times were calculated for each racial and income group, and log-rank tests were used to compare survival differences across the groups. Results: A total of 11,214 individuals under 60 years of age diagnosed with cholangiocarcinoma were included. Median all-cause survival was 12.0 months for Asian patients, 11.0 months for White patients, and 9.0 months for both Black and Hispanic patients. Significant differences were observed between Asian vs White (p < 0.005), Asian vs Black (p < 0.005), Asian vs Hispanic (p < 0.005), White vs Black (p < 0.005), and White vs Hispanic (p < 0.005), with no significant difference between Black and Hispanic patients (p = 0.859). For cancer-free survival, the median was 13.0 months for Asians, 12.0 months for Whites, 11.0 months for Blacks, and 10.0 months for Hispanics, with significant differences between Asian vs Black (p < 0.005), Asian vs Hispanic (p < 0.005), and White vs Black (p = 0.017). The difference between Asian vs White was not statistically significant (p = 0.052), and no significant difference was observed between White vs Hispanic (p = 0.418) or Black vs Hispanic (p = 0.418). By income, patients with an income >$75,000 had significantly longer all-cause survival (12.0 months vs 9.0 months, p < 0.005) and cancer-free survival (13.0 months vs 11.0 months, p < 0.005) compared to those with an income of $0-$75,000. Conclusions: Significant disparities in cancer-free and all-cause survival were found based on ethnicity and income. Asian and White patients had longer survival compared to Black and Hispanic patients, and higher-income patients experienced better outcomes. These findings highlight the need for targeted efforts to address healthcare inequalities in cholangiocarcinoma care.