Abstract A102: Association between neighborhood-level socioeconomic deprivation and colon cancer recurrence following colectomy: A retrospective study

Abstract Background: Living in a socioeconomically disadvantaged neighborhood results in worse oncologic outcomes for patients diagnosed with colon cancer, yet its role in colon cancer recurrence after surgery is not well understood. Up to 30% of patients with non-metastatic colon adenocarcinoma experience recurrence following colectomy. Here, we examined the association between neighborhood-level socioeconomic deprivation and postoperative recurrence among patients at the University of Chicago Comprehensive Cancer Center. Methods: We included patients aged ≥18 years diagnosed with stage I–III colon adenocarcinoma between 2015 and 2024 who underwent colectomy. Patient data were obtained from our institutional cancer registry and linked to Area Deprivation Index (ADI) scores at the census tract level based on the 2023 American Community Survey. A validated measure of neighborhood-level socioeconomic disadvantage, ADI scores range from 0 (least disadvantaged) to 100 (most disadvantaged). Multivariable Cox regression was used to assess the association between ADI (analyzed both by quartile and as a continuous variable) and two outcomes: time to recurrence (TTR) and recurrence-free survival (RFS), within 2 years post-operatively, adjusting for age at colectomy, adjuvant chemotherapy, AJCC pathologic stage, race and ethnicity, and insurance type. Results: 189 patients met the study inclusion criteria. The mean age of the cohort was 65.9 years (SD 14.3), 50.3% were female, and 48.1% were Black, 41.8% White, 5.3% Asian, and 4.8% Hispanic. Tumor stage distribution was 22.9% stage I, 36.7% stage II, and 40.4% stage III. Black patients had the greatest mean ADI score (65.7, SD 18.8), followed by Hispanic (53.2, SD 18.0), White (42.0, SD 21.6), and Asian (38.5, SD 18.3) patients (p<0.001). Patients with Medicaid had the highest mean ADI (72.2, SD 13.7), followed by those with Medicare (58.3 SD 21.9) and private insurance (45.1 SD 24.8) (p=0.001). By pathologic stage, patients with stage III disease had the highest mean ADI (59.3 SD 23.9), followed by stage I (53.6 SD 22.5), then stage II (50.0 SD 21.4) (p=0.048). Median follow-up time was 1.1 years, and 25.4% developed a postoperative recurrence within two years of surgery. A higher ADI score was significantly associated with increased risk of recurrence or death (adjusted hazard ratio [AHR] for RFS, 1.03; 95% CI 1.00-1.05; p=0.046). There was a similar but non-significant trend for TTR (AHR 1.02; 95% CI 0.99-1.05; p=0.099). Analyses using ADI quartiles revealed a stepwise increase in recurrence risk with higher ADI quartiles, though this trend did not reach statistical significance. Conclusions: In this single-institution retrospective cohort study of patients with non-metastatic colon cancer, each one-point increase in neighborhood-level deprivation was associated with a 3% increase in the hazard of recurrence or death within 2 years of colectomy. Further research to understand this association can help identify patients at high risk of recurrence and inform targeted surveillance strategies. Citation Format: Armaan Jamal, Jincong Q. Freeman, Claire Wild, Jasmin Tiro, Kayla Councell, Benjamin D. Shogan. Association between neighborhood-level socioeconomic deprivation and colon cancer recurrence following colectomy: A retrospective study [abstract]. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A102.