Hoda Anton-Culver

Background: Literature on colorectal cancer outcomes in individuals of Middle Eastern and North African (MENA) descent is 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 individuals. For each racial/ethnic group, we calculated five-year colorectal 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.