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May 30, 2026Journal of Clinical Oncology

Rural non-Hispanic Black patients in the highest deprivation quintile had the greatest odds of late-stage colorectal cancer diagnosis (71.4% late stage; aOR 2.34).

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Population

156,847 adults aged 50–75 diagnosed with colorectal cancer across 17 SEER registries (2016–2021)

Design

Cohort

Key result

Rural non-Hispanic Black patients in the highest deprivation quintile had the greatest odds of late-stage colorectal cancer diagnosis (71.4% late stage; aOR 2.34).

Authors

COChiugo OkoyeCEChinemerem M EmeasobaCOChidi Obialo-Ibeawuchi

Discussion

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Overview

Race/ethnicity, geography, and socioeconomic deprivation exert synergistic effects on colorectal cancer stage at diagnosis, disproportionately affecting rural NHB and AI/AN populations in highly deprived areas.

Key Points

  • The aim is to evaluate how race/ethnicity, geography, and socioeconomic status intersect to affect colorectal cancer screening and stage at diagnosis.
  • Analyzed SEER data (2016–2021) for adults aged 50–75 with CRC across 17 registries.
  • Classified patients by race/ethnicity, geography, and neighborhood deprivation, using multivariable logistic regression for analysis.
  • Assessed temporal trends in disparities over time with interaction terms for synergistic effects.
  • 39.4% of patients diagnosed at localized stage; NHB patients had higher odds of late-stage diagnosis (aOR 1.31, 95% CI 1.26–1.36).
  • Rural residence (aOR 1.18) and highest ADI quintile (aOR 1.52) were linked with late-stage diagnosis.
  • Rural NHB patients in highest deprivation had the greatest burden (aOR 2.34) and disparities widened from 2016 to 2021.

Study Design

Type

Observational (n=156,847)

Multicenter

Yes

Structured PICO

P
Population
156,847 adults aged 50–75 diagnosed with colorectal cancer across 17 SEER registries (2016–2021)
O
Outcome
Stage at diagnosis (localized vs regional/distant)hard clinical

Main Result

Effect estimate: aOR 1.31 (95% CI 1.26-1.36)

Race/ethnicity, geography, and socioeconomic deprivation exert synergistic effects on colorectal cancer stage at diagnosis, disproportionately affecting rural NHB and AI/AN populations in highly deprived areas.

Cite This Study

Okoye et al. (2026) conducted an observational in Colorectal cancer (n=156,847). Social determinants of health (race/ethnicity, geography, socioeconomic status) was evaluated on Late-stage diagnosis (regional/distant) (aOR 1.31, 95% CI 1.26-1.36). Rural non-Hispanic Black patients in the highest deprivation quintile had the greatest odds of late-stage colorectal cancer diagnosis (71.4% late stage; aOR 2.34).

synapsesocial.com/papers/6a1a808f0307b7850943282ahttps://doi.org/10.1200/jco.2026.44.16_suppl.e15714
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