S580 Consideration of Race and Ethnicity in Evaluating Outcomes of Colorectal Cancer With Increasing Age

Introduction: Accelerated biological aging in certain racial/ethnic groups has been described with concern for widening disparities with increasing age. With the lack of evidence for cancer patients, we sought to determine the relationship of racial/ethnic disparities in colorectal cancer (CRC) outcomes and age. Methods: Retrospective analysis of National Cancer Database from 2010 to 2021 was performed using age at diagnosis of CRC for cohorts: <65, 65-69, 70-74, 75-79, and ≥80 years. Race/ethnicity included: non-Hispanic White, Black, Hispanic, Asian/Pacific Islander (API), and American Indian/Aleutian/Eskimo (AIAE). Primary outcomes were overall survival (OS) and 90-day postoperative mortality (PM) after surgery. We used multivariable Cox proportional hazard and logistic regression models. Results: The median OS in Blacks ranged from 64.13 months in <65 years cohort (vs 126.98 months for Whites; HR 1.28, 95% CI 1.26-1.30) and 19.15 months in ≥80 years cohort (vs 26.45 months for Whites; HR 1.06, 95% CI 1.03-1.09). The Hispanic and API race/ethnicity were associated with improved OS compared to Whites. The 90-day PM showed similar trends between Black and White patients with OR 1.23 (95% CI 1.15-1.31) in the <65 years cohort and OR 1.11 (95% CI 1.01-1.22) in the ≥80 years cohort. Notably, AIAE race was associated with an increased 90-day PM in 70-74 years (OR 2.65, 95% CI 1.67-4.20) and 75-79 years (OR 1.94, 95% CI 1.07-3.53) cohorts but had similar OS compared to Whites. Conclusion: While disparities persist throughout age, in contrast to non-oncological literature, we found larger racial/ethnic outcome disparities in younger age groups for those with CRC except in AIAEs.