Disparities in presentation, treatment, and overall survival for South Asian American patients with colorectal cancer

e15554 Background: The South Asian population in America is growing. Colorectal Cancer (CRC) is one of the most common cancers amongst South Asian Americans (SAA), however few studies have looked at differential presentation, treatment, and outcomes. The objective of this study was to compare differences in presentations, and investigate disparities in treatment and overall survival (OS) amongst SAAs compared with non-Hispanic whites (NHW). Methods: We performed a retrospective analysis of patients with colon or rectal adenocarcinoma in the National Cancer Database (NCDB) years 2004-2020. We compared differences in patient demographics, socioeconomics, stage at presentation, and treatments received between SAA and NHW populations using chi square, and t tests as applicable. OS was evaluated using Kaplan-Meier analysis and the log-rank test. Multivariable Cox regression stratified by stage was used to compare OS between the two groups. Results: We analyzed data from 773,223 NHW and 3,448 SAA patients with colon cancer (CC) and 285,769 NHW and 1,826 SAA patients with RC. At presentation SAAs were younger (61.2 years vs 69.2 years, p<0.001 for CC, and 57.9 vs 63.9, p<0.001 for RC), less likely to have government insurance (44.1% vs 64.1%, p<0.001 for CC, and 35.4% vs 50.6%, p<0.001 for RC), more likely to be living in metropolitan areas (97.9% vs 83.2%, p<0.001 for CC, and 97.4% vs 81.0%, p<0.001 for RC), and more likely to have advanced stages of disease (47.4% vs 42.7%, p<0.001 for CC, and 40.9% vs 38.9%, p<0.001 for RC). SAAs had significantly longer delay in receipt of surgical intervention or radiation therapy (p <0.001) and were less likely to receive surgery for stage 4 for CC (54.6% vs 60.5%, p<0.001). On multivariate cox regression, adjusted for age, sex, insurance status, urban/rural location, and comorbid conditions, SAAs with either colon or rectal cancer were more likely to survive across all cancer stages (p<0.001). Conclusions: In this national study, when compared to NHW patients, SAA patients with CRC, present at younger ages and with more aggressive disease. Despite SAAs being less likely to receive timely cancer care, they have better overall survival. [Table: see text]