A National Study of Colorectal Cancer Survivorship Disparities: A Latent Class Analysis Using SEER (Surveillance, Epidemiology, and End Results) Registries

• Main Authors: Francisco A. Montiel Ishino (Author), Emmanuel A. Odame (Author), Kevin Villalobos (Author), Xiaohui Liu (Author), Bonita Salmeron (Author), Hadii Mamudu (Author), Faustine Williams (Author)
• Format: Book
• Published: Frontiers Media S.A., 2021-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2296-2565; 10.3389/fpubh.2021.628022
• Keywords: colorectal (colon) cancer; cancer health disparities; latent class analyses; survivorship (public health); person-centered analysis; Public aspects of medicine; RA1-1270
• Source: Frontiers in Public Health, Vol 9 (2021)

Introduction: Long-standing disparities in colorectal cancer (CRC) outcomes and survival between Whites and Blacks have been observed. A person-centered approach using latent class analysis (LCA) is a novel methodology to assess and address CRC health disparities. LCA can overcome statistical challenges from subgroup analyses that would normally impede variable-centered analyses like regression. Aim was to identify risk profiles and differences in malignant CRC survivorship outcomes.Methods: We conducted an LCA on the Surveillance, Epidemiology, and End Results data from 1975 to 2016 for adults ≥18 (N = 525,245). Sociodemographics used were age, sex/gender, marital status, race, and ethnicity (Hispanic/Latinos) and stage at diagnosis. To select the best fitting model, we employed a comparative approach comparing sample-size adjusted BIC and entropy; which indicates a good separation of classes.Results: A four-class solution with an entropy of 0.72 was identified as: lowest survivorship, medium-low, medium-high, and highest survivorship. The lowest survivorship class (26% of sample) with a mean survival rate of 53 months had the highest conditional probabilities of being 76-85 years-old at diagnosis, female, widowed, and non-Hispanic White, with a high likelihood with localized staging. The highest survivorship class (53% of sample) with a mean survival rate of 92 months had the highest likelihood of being married, male with localized staging, and a high likelihood of being non-Hispanic White.Conclusion: The use of a person-centered measure with population-based cancer registries data can help better detect cancer risk subgroups that may otherwise be overlooked.