Age-related disparities in survival following colorectal cancer diagnosis in an underserved community in Georgia: A retrospective cohort analysis

Introduction: Limited studies have examined disparities regarding age at diagnosis and 5-year overall survival (OS) following colorectal cancer (CRC) diagnosis within medically underserved areas in Georgia. The study aim was to examine this association and determine key factors of 5-year survival within four age groups in Augusta-Richmond County, Georgia. Materials and Methods: We conducted a retrospective cohort analysis using 2012–2022 data from an institutional cancer registry linked with medical records and billing data from a single cancer center in Georgia. Multivariable Cox proportional hazard regression models were used. Results: Among 839 patients with CRC, 5-year survival rates were lowest among patients aged 70+ years (54.9 % vs. 63.4 % for 60–69 years, 67.2 % for 50–59 years, and 67.4 % for 18–49 years) (p < 0.001). Patients with CRC with a late stage at diagnosis were associated with increased risk of death by 2 to 7 times (18–49 years: HR, 5.45; 95 % CI, 2.28–10.55; 50–59 years: HR, 6.72; 95 % CI, 4.08–11.06; 60–69 years: HR, 5.98; 95 % CI, 3.92–9.10; 70+ years: HR, 2.21; 95 % CI, 1.41–3.46). Further, 50–59-year-old former smokers had an increased risk of death (HR, 2.16; 95 % CI, 1.11–4.20). Patients aged 60–69 years and living in persistent poverty areas also had an increased risk of death (HR, 1.85; 95 % CI, 1.20–2.85). Discussion: Advanced diagnoses were associated with a greater risk of mortality regardless of age group. Former smokers and those living in persistent poverty areas were also linked to increased mortality for 50–59 and 60–69 age groups, respectively. Improving equitable access to screening facilities/ cancer treatment resources and promoting healthy lifestyles are critical.