Poverty, Rurality Associated With Early Onset CRC Mortality

Researchers using data from the Surveillance, Epidemiology, and End Results (SEER) Program found that patients with early-onset colorectal cancer (EO-CRC) who lived in rural and low-income areas had a higher risk of death compared to patients in urban and nonpoverty areas.

The investigators analyzed EO-CRC survival from 2006 to 2015, focusing on persistent poverty—defined as 20% or more of a population living below the poverty line for 30 years—and rurality. Among 58,200 patients with EO-CRC, patients in rural areas had a 1.1- to 1.4-fold increased risk of CRC death, while those in both rural and poverty-stricken areas faced a 1.1- to 1.5-fold greater risk. The risk was particularly high for patients aged 30 to 39, with a 50% higher mortality rate compared to urban counterparts.

The findings suggest that later-stage diagnoses, lack of insurance, and lower-quality care in rural or impoverished regions may contribute to the higher mortality rates. Additionally, higher rates of comorbidities such as obesity could complicate treatment outcomes.

While the study’s limitations include its inability to account for other confounders such as lifestyle factors and structural barriers, the findings emphasize the need for targeted interventions in under-resourced areas, such as education programs and early diagnosis initiatives, to improve EO-CRC outcomes.

Reference
Tsai MH, Coughlin SS, Cortes J, Thompson CA. Intersection of poverty and rurality for early-onset colorectal cancer survival. JAMA Netw Open. 2024;7(8):e2430615. doi:10.1001/jamanetworkopen.2024.3061