Ancestry-linked, stage-specific delay to tertiary care is associated with survival differences in colorectal cancer
Presenter: Sharafudeen Abubakar, PhD Session: Etiology and Molecular Epidemiology Approaches to Decipher Cancer Disparities Time: 4/21/2026 9:00:00 AM → 4/21/2026 12:00:00 PM
Authors
Sharafudeen Dahiru Abubakar , Henry Walch , Christina Lee , David Gomez Sanchez , Chin-Tung Chen , Stefanie Gerstberger , Kanika Arora , Farheen Shah , Tejiri E. Agbamu , Michele Waters , Christopher J. Fong , Justin Jee , Michael F. Berger , Karuna Ganesh , Debyani Chakravarty , Walid Khaled Chatila , Nikolaus Schultz , Rona Yaeger , Julio Garcia-Aguilar , Francisco Sanchez-Vega Memorial Sloan Kettering Cancer Center, New York, NY
Abstract
Background: African-ancestry (AFR) patients with colorectal cancer (CRC) have worse overall survival (OS) than non-AFR patients. While biological and socioeconomic (SES) factors are known to play a role, delayed access to specialized care remains a critical, underexplored driver of this inequity. This study investigates how the time from diagnosis (Dx) to arrival at a tertiary cancer center interacts with ancestry, disease stage, SES, and genomics to affect OS. Methods: We analyzed data from 4,328 CRC patients (259 AFR, 4,069 non-AFR) treated at Memorial Sloan Kettering Cancer Center (MSK) since 2014. Tumors were sequenced with MSK-IMPACT, a targeted DNA sequencing assay that profiles genomic changes in 341-505 genes. Genetic ancestry was inferred from sequencing data with >80% African ancestry fraction grouped as AFR. OncoKB identified clinically actionable genomic alterations. Covariates included tumor location, stage at Dx, time from Dx to MSK arrival (Early ≤90 days vs Late >90 days), insurance type and metastatic burden. OS from Dx was compared using Kaplan-Meier curves and log-rank test, with left-truncation for genomic sequencing date. Results: AFR patients had worse OS from Dx than Non-AFR patients (median 39.3 vs 62.7 months, p Conclusion: Delayed specialized care appears to be linked to CRC survival gaps in AFR patients, especially in the non-metastatic setting where timely multidisciplinary care is crucial. Expediting referral of AFR patients to tertiary care centers could help to achieve CRC outcome equity.
Disclosure
S. D. Abubakar, None.. C. Lee, None.. C. Chen, None.. F. Shah, None.. M. Waters, None.
Cited in
Control: 1368 · Presentation Id: 2882 · Meeting 21436