Demographic and clinical disparities in rectal cancer survival: A retrospective cohort analysis using Surveillance, Epidemiology, and End Results (SEER) data (2014–2020).

e15616 Background: Rectal cancer is a significant global health concern with survival rates varying by stage at diagnosis, age, sex, and race/ethnicity. This study evaluates the SEER 5-year relative survival rates for rectal cancer (2014–2020) to identify demographic and clinical disparities. Methods: A retrospective cohort study was conducted using data from the SEER 22 registries (excluding Illinois and Massachusetts) for rectal cancer cases diagnosed between 2014 and 2020. Survival rates were stratified by stage at diagnosis (localized, regional, distant, unstaged), sex, age, and race/ethnicity. Statistical analysis and survival rate estimations were performed using SEER*Stat software, with confidence intervals computed to assess precision. Results: The 5-year relative survival rate for localized rectal cancer was 90% (CI: 89.5–90.5), decreasing to 73.8% (CI: 73.2–74.5) for regional disease and 18% (CI: 17.3–18.7) for distant metastases. Females showed slightly higher survival rates than males across all stages, with localized survival at 91.1% versus 89.2%, respectively. Patients under 50 years had the highest localized survival (94.5%, CI: 93.5–95.3), while those aged 65+ had the lowest (83.4%, CI: 82.2–84.5). Racial disparities were evident, with Non-Hispanic Asian/Pacific Islanders achieving the highest localized survival (91.4%, CI: 89.8–92.8), and Non-Hispanic American Indian/Alaska Natives the lowest (87.8%, CI: 78.0–93.4). Conclusions: This study highlights significant survival disparities in rectal cancer based on stage, sex, age, and race/ethnicity. Early detection and equitable healthcare access are essential to improving outcomes.