Differences in Stage-Specific Survival for Colorectal Cancer in Asian Subgroups by Census Tract Education

Background: Few studies exist analyzing the relationship between socioeconomic status (SES) indicators and colorectal cancer (CRC) survival among Asian subgroups. This investigation examines differences in CRC stage and survival by census tract education among 5 Asian subgroups. Methods: Data on 151,284 CRC cases diagnosed in 1992-2002 from 13 population-based cancer registries participating in the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program were linked to census tract education (SES indicator). Five-year cause-specific survival rates were calculated for Chinese, Japanese, Filipinos, Koreans, and Vietnamese. Results: Compared to Chinese, Vietnamese, Filipinos, and Japanese, Koreans tended to have worse survival rates for earlier stages in both males and females and for later stages in males. Japanese tended to have better survival rates regardless of stage than other Asian groups. Among all SES groups, survival decreased with advancing stage. However, patients in low SES tracts did not necessarily have significantly lower rates of survival. For example, while Vietnamese women and Korean men in the high education census tract had higher survival rates compared to their counterparts in the low education tract for every stage, Korean women showed worse survival rates in the high SES group than in the low SES group, especially in earlier stages. Conclusions: SES indicators such as education may help explain some of the stage-specific survival differences among Asian subgroups. However, the considerable variation observed in survival patterns across these groups warrants further investigation to better understand the relationship between SES and CRC survival.