Survival of Middle Eastern and North African Individuals Diagnosed with Colorectal Cancer: A Population-Based Study in California

Background: Literature on colorectal cancer outcomes in indi-viduals of Middle Eastern and North African (MENA) descent limited. To address this gap, we estimated five-year colorectal cancer-specific survival by race and ethnicity, including MENA individuals, in a diverse, population-based sample in California. Methods: We identified adults (ages 18-79 years) diagnosed with a first or only colorectal cancer in 2004 to 2017 using the California Cancer Registry (CCR), including non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic, and MENA indi-viduals. For each racial/ethnic group, we calculated five-year colo-rectal cancer-specific survival and used Cox proportional hazards regression models to examine the association of race/ethnicity and survival, adjusting for clinical and socio demographic factors. Results: Of 110,192 persons diagnosed with colorectal cancer, five-year colorectal cancer-specific survival was lowest in Black (61.0%) and highest in MENA (73.2%) individuals. Asian (72.2%) individuals had higher survival than White (70.0%) and Hispanic (68.2%) individuals. In adjusted analysis, MENA [adjusted HR (aHR), 0.82; 95% confidence interval (CI), 0.76-0.89], Asian (aHR, 0.86; 95% CI, 0.83-0.90), and Hispanic (aHR, 0.94; 95% CI, 0.91-0.97) race/ethnicity were associated with higher, and Black (aHR, 1.13; 95% CI, 1.09-1.18) race/ethnicity was associated with lower survival compared with non-Hispanic White race/ethnicity. Conclusions: To our knowledge, this is the first study to report colorectal cancer survival in MENA individuals in the United States. We observed higher survival of MENA individuals compared with other racial/ethnic groups, adjusting for sociodemographic and clinical factors. Impact: Future studies are needed to identify factors contributing to cancer outcomes in this unique population.

Automated summary

This study compared the survival rates of colorectal cancer in individuals of Middle Eastern and North African (MENA) descent with other racial/ethnic groups, including non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, and Hispanic individuals, in a diverse population-based sample in California. The study found that MENA individuals had the highest five-year colorectal cancer-specific survival rate (73.2%), while Black individuals had the lowest (61.0%). Asian, Hispanic, and MENA race/ethnicity were associated with higher survival, while Black race/ethnicity was associated with lower survival compared to non-Hispanic White race/ethnicity.