Disparities in Colorectal Cancer Presentation at a National Cancer Institute-Designated Cancer Center and a Safety-Net Hospital during the COVID-19 Pandemic

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Published Sep 2, 2024
DOI: https://doi.org/10.18103/mra.v12i8.5761

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Main Article Content

Munir H. Buhaya
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA
Megan Turley
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA
Ofelia Negrete Vasquez
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA
Nicholas Bryant
Department of Surgery, Parkland Health and Hospital, 5200 Harry Hines Blvd, Dallas, TX 75235, USA
Baqir Jafry
Department of Internal Medicine, University of Texas Southwestern, 5323 Harry Hines Blvd.
Sitaram Chilakamarry
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA;  Department of Surgery, Parkland Health and Hospital, 5200 Harry Hines Blvd, Dallas, TX 75235, USA
Javier Salgado Pogacnik
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA;  Department of Surgery, Parkland Health and Hospital, 5200 Harry Hines Blvd, Dallas, TX 75235, USA
Syed M. Kazmi
Department of Internal Medicine, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA;  Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, 6202 Harry Hines Blvd, Dallas, TX 75235, USA
Emina H. Huang
Department of Surgery, University of Texas Southwestern, 5323 Harry Hines Blvd. Dallas, TX 75390, USA;  Department of Surgery, Parkland Health and Hospital, 5200 Harry Hines Blvd, Dallas, TX 75235, USA;  Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern, 6202 Harry Hines Blvd, Dallas, TX 75235, USA

Abstract

Background: The clinical setting where patients with colorectal cancer (CRC), especially young adults, accessed the healthcare system during the COVID-19 pandemic to obtain their diagnosis is understudied. We hypothesized that patients with early-onset CRC (EO-CRC) present at disproportionate rates to emergency departments compared to patients with average-age onset CRC (AO-CRC).


Patient and Methods: Clinical chart review was conducted for patients discussed at tumor board from the University of Texas Southwestern and Parkland Health Hospitals from August 2020 to August 2022 to compare the site of presentation that led to diagnosis: emergency department or primary care setting.


Results: Two-hundred and ninety-three patients with CRC were included (69% AO-CRC, 31% EO-CRC), presenting at similar rates to primary care providers and emergency department (55% vs 45%, respectively). Most patients who presented to the emergency department received their cancer care at the safety net hospital (70%, p <0.001). Race/ethnicity, and comorbidities like obesity and metabolic dysregulation were also associated with emergency department presentation. Patients from the safety net hospital and those with obesity-related comorbidities were more likely present to the emergency department (OR 5.98, 95% CI 2.88 - 12.41, p<0.001; OR 4.18, 95% CI 1.18 - 14.81, p=0.03). Patients with rectal cancer are less likely to present to the emergency department (OR 0.42, 95% CI 0.21 - 0.85, p=0.02). No differences were observed between EO-CRC and AO-CRC with respect to the presentation site.


Conclusion: Here we identified factors linked to CRC diagnostic access to the healthcare system during the COVID-19 pandemic in a racially and ethnically diverse population. Future research in this area can inform specialized CRC screening and diagnostic pathways for vulnerable young adults, guiding resource allocation to improve access to care and prompt diagnosis. Additionally, these insights can guide diagnostic access plans during global health crises for at-risk populations.

Keywords: Early onset colorectal cancer, colon cancer, rectal cancer, racial disparities, gender disparities

Article Details

How to Cite
BUHAYA, Munir H. et al. Disparities in Colorectal Cancer Presentation at a National Cancer Institute-Designated Cancer Center and a Safety-Net Hospital during the COVID-19 Pandemic. Medical Research Archives, [S.l.], v. 12, n. 8, sep. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5761>. Date accessed: 05 sep. 2024. doi: https://doi.org/10.18103/mra.v12i8.5761.
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Vol 12 No 8 (2024): Vol 12 No 8 (2024): August ISSUE, Issue 8, VOl.12
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Research Articles

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