Title: “Beyond Race Alone: The Intersection of Race and Socioeconomic Status in Association with Colorectal Cancer Mortality”
Background: Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States, with large racial disparities in mortality potentially driven by factors such as income, education, and screening. We examined the relation between race and CRC mortality and how sociodemographic, clinical, and lifestyle factors may mediate this relation in the Southern Community Cohort Study (SCCS).
Methods: Participants (n=1040; 74.13% non-Hispanic Black) were recruited between 2002-2009 and diagnosed with incident CRC after enrollment. Sociodemographic, clinical, and lifestyle information was collected through standardized questionnaires and interviews. Cox proportional hazard models were used to estimate the association between race and aforementioned factors with mortality.
Results: Race or income individually was not associated with overall- or CRC-specific mortality. In an intersecting variable between race and income, lower CRC mortality was observed for Black participants earning ≥$50,000 (HR[95% CI]: 0.49[0.25-0.97]) and White participants earning ≥$50,000 (0.50[0.27-0.94]), compared to Black participants earning <$15,000 per year. Similar associations were observed for overall mortality.
Conclusion: Race and income together may play a greater role in CRC mortality-related disparities than race alone in this cohort. Policies should prioritize reducing financial barriers and expanding screening to improve access and outcomes.
