Immigrant Health and Early-Onset Colorectal Cancer Disparities: Results From the Spanish Early-Onset Colorectal Cancer Consortium
José Perea, Marc Martí-Gallostra, Ariadna García-Rodríguez, Rosario Vidal-Tocino, José A. Alcázar, Irene López-Rojo, Sara Encinas García, Elena Hurtado, Luis M. Jiménez, Edurne Álvaro, Ana Burdaspal, Gonzalo Sanz, Rodrigo Sanz López, Marta Jiménez Toscano, Mar Iglesias Comas, Fernando Jiménez, Adriana Cavero, Francesc Balaguer, María Daca, Araceli Ballestero, Javier Die Trill, Sirio Melone, José A. Rueda, Sergio Hernández-Villafranca, Damián García-Olmo, Carlos Pastor, Alicia Alvarellos, Lorena Brandáriz, Cristina Viyuela, Alfredo Vivas, Paula Muñoz, Rogelio González-Sarmiento, Andreana N. Holowatyj, , Edgardo Celi Altamarina, Elena García, Ma del Mar Pardo, Laura Vega López, Manuel Escanciano, Vicente Portugal, María Arriba Domenech, Isabel Peligros Gómez, Jaime Zorrilla Ortúzar, María Daca, Teresa Ocaña, Joaquín Castillo, Miriam Cuatrecasas, Sabela Carballal, Hardeep Kumari, Leticia Moreira, Lorena Moreno, María Pellisé, Ariadna Sánchez, Ana Ramírez de Molina, Gonzalo Colmenarejo, Isabel Espinosa-Salinas, Lara P. Fernández, Marta Gómez de Cedrón, Luis Corchete, Juan L. García, Paula García-Vallés, Ana B. Herrero, Jésica Pérez, Maria Luisa de Fuenmayor, Oscar Alonso, Sara Encinas, Ana Teijo, Jorge Arredondo, Ignacio Matos, Javier Rodríguez, Alba Fernández Candela, José Ma Fernández Cebrián, Juan Ocaña Jiménez, Jana Dziakova, Sara Picazo Marín, María Suárez Solís, Francisco Blanco Antona, Núria Malats, Lidia Estudillo, Miquel Kraft, Franco Marinello, Ignacio ValverdePURPOSE
To better understand immigration disparities among a Spanish Early-Onset Colorectal Cancer (SECOC) subset, according to the country of origin.
PATIENTS AND METHODS
We selected 250 consecutive participants from the SECOC consortium. Data on baseline patient and tumor characteristics, family history of colorectal cancer (CRC), and follow-up were collected. The presence of mismatch repair deficiency was also assessed. Special data regarding country of origin, time of stay in Spain in case of other different country, and a 10-year cutoff that specifies the obtaining of Spanish nationality defined the variables of interest for comparison.
RESULTS
Seventy-five percent of patients with early-onset CRC (EOCRC) (188) were born in Spain, whereas the other 25% were born outside of Spain. The mean time of living in Spain until the EOCRC diagnosis was 16.5 years. Comparatively, most of the analyzed features showed equivalent proportions between cohorts. Only Spanish patients appeared to have more familial cancer component in first degree in general (32.3%; P = .01), compared with non-Spaniards, which showed a predominant sporadic component (56.4%; P < .001). Among immigrants, those patients living in Spain before CRC diagnosis ≤10 years were younger at diagnosis (39.1 v 42.5), more frequently male (77.8 v 47.7), were in more advanced stages (88.8% diagnosed at stage III and IV [ P = .01]), and had a worse prognosis regarding recurrence rates (29.4% v 6.3%).
CONCLUSION
Although there were few differences between Spanish and non-Spanish EOCRC, the most remarkable difference was that linked with the situation of those immigrants who have recently arrived in Spain, in relation to their lower health coverage, which could be associated with the delay in the diagnosis and their subsequent worse prognosis.