P0202 - Investigating Racial, Gender, and Socioeconomic Disparities in Individuals With Colorectal Cancer: A Study Utilizing the NIH All of Us Database

Noah Osei, MD¹, Yong Eun, MD², Kesiena Akpoigbe, MD¹, Joan Culpepper-Morgan, MD, FACG^3
1Harlem Hospital Center, New York, NY; ²Harlem Hospital Center - NYCHHC, New York, NY; ³Harlem Hospital, New York, NY

Introduction: Colorectal cancer (CRC) is associated with considerable morbidity and mortality. Race/ ethnicity, gender, education, and income have been recognized as potential determinants of health outcomes. The National Institutes of Health (NIH) All of Us database is a relatively new repository of clinical information. Our aim was to query the All of Us database to determine if factors previously associated with the occurrence of CRC are still valid in this cohort.

Methods: This was a cross-sectional study, that examined data from 287,012 patients with available electronic health record data. Using ICD 9/10 codes, we identified patients diagnosed with CRC. We then utilized questionnaire response data to analyze specific characteristics of patients with and without CRC. These characteristics included gender, race/ ethnicity, income level, education level, and smoking. We also compared metabolic syndrome related diagnoses between patients with CRC and those without. All analyses were carried out on the Jupyter Notebook web-based platform using the R programming language.

Results: Among those without CRC (N = 284,297), 60.1% were female, versus 54.8% (N = 2,715) in the CRC group (p < 0.001). Individuals with CRC were older (68.4 vs 54.9 years, p< 0.001) and a higher percentage were White (66.6 vs 53.8). A lower percentage of Black (13.6 vs 20.4), Asian (1.8 vs 2.9), and Hispanic (13.6 vs 18.9) patients were in the CRC group compared to the non-CRC group (p< 0.001). More individuals with CRC were in the higher income range of ≥$100,000 (22.6%) compared to the non-CRC group (19.9%). Fewer were in the low-income range, < $25,000 (20.1%) compared to the non-CRC group (26.1%) (p< 0.001). Those with CRC had a higher percentage of college graduates or advanced degree holders (47.7%) than those without CRC (41.8%). There were more smokers in the CRC group (45.3%) compared to those without CRC (39.9%) (p< 0.001). Similarly, the prevalence of obesity, diabetes, hypertension, and hyperlipidemia was significantly higher among those with CRC than those without (p< 0.001) (Table 1).

Discussion: We find the All of Us database subjects to be generally wealthier and more educated than previously queried databases. Notably, Black and Hispanic groups were not over represented in the CRC group. Wealth and education may have minimized disparities due to race/ethnicity. Nevertheless, lifestyle choices reflected in the presence of smoking and metabolic syndrome continued to be increased in the CRC group.



Disclosures:


Noah Osei, MD¹, Yong Eun, MD², Kesiena Akpoigbe, MD¹, Joan Culpepper-Morgan, MD, FACG³. P0202 - Investigating Racial, Gender, and Socioeconomic Disparities in Individuals With Colorectal Cancer: A Study Utilizing the NIH All of Us Database, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.