{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:39:15Z","timestamp":1787978355189,"version":"build-2784847793"},"reference-count":46,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health","award":["R01CA259420"],"award-info":[{"award-number":["R01CA259420"]}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"crossref","award":["NU58DP007112"],"award-info":[{"award-number":["NU58DP007112"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["HHSN2612018000071"],"award-info":[{"award-number":["HHSN2612018000071"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: While colorectal cancer (CRC) incidence and mortality have declined among patients aged \u226550 years (late-onset), rates are increasing in those aged &lt;50 years (early-onset). Historically, non-Hispanic Whites (NHW) have had better 5-year survival compared with non-Hispanic Blacks (NHB), and rectal cancer has had better outcomes than colon cancer. Whether these disparities by race and tumor location are evident for both early-onset (EOCRC) and late-onset (LOCRC) CRC remains unclear. Methods: CRC cases diagnosed from 2011 to 2022 were identified from the Louisiana Tumor Registry. EOCRC was defined as diagnoses at ages 20\u201349 years, and LOCRC was defined as diagnoses at ages \u226550 years. Racial groups included NHW and NHB; tumor location was categorized as proximal colon, distal colon, or rectum. Cox regression was used to assess unadjusted and adjusted overall and cancer-specific survival. Results: Of 23,738 CRC patients, 10.7% were diagnosed at age &lt;50 years. Compared to LOCRC, EOCRC patients included a higher proportion of NHB (37.5% vs. 32.6%) and rectal tumors (44.4% vs. 29.9%). NHB had worse overall survival than NHW in early-onset distal colon cancer (adjusted HR [aHR] = 1.358; 95%CI: 1.024\u20131.801). Conversely, NHB had better overall (aHR = 0.899; 95%CI: 0.831\u20130.973) and cancer-specific survival (aHR = 0.873; 95%CI: 0.793\u20130.960) in late-onset rectal cancer. Among EOCRC NHW, proximal tumors were associated with worse overall (aHR = 1.407; 95%CI: 1.102\u20131.796) and cancer-specific survival (aHR = 1.379; 95%CI: 1.057\u20131.799) compared with distal tumors. Conclusions: Survival differences by race and tumor subsite are observed between EOCRC and LOCRC, with NHB showing a lower hazard of death in some LOCRC subgroups. These findings highlight the need to consider the age of onset and tumor location when addressing racial disparities in CRC outcomes.<\/jats:p>","DOI":"10.3390\/cancers18020180","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T08:42:58Z","timestamp":1767688978000},"page":"180","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Race and Tumor Subsite on Survival Outcome in Early- and Late-Onset Colorectal Cancer"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7842-1225","authenticated-orcid":false,"given":"Mei-Chin","family":"Hsieh","sequence":"first","affiliation":[{"name":"Epidemiology and Population Health Program, Louisiana Tumor Registry, School of Public Health, Louisiana State University Health-New Orleans, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena M.","family":"Stoffel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI 48109, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Purrington","sequence":"additional","affiliation":[{"name":"School of Medicine, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3663-5027","authenticated-orcid":false,"given":"Xiao-Cheng","family":"Wu","sequence":"additional","affiliation":[{"name":"Epidemiology and Population Health Program, Louisiana Tumor Registry, School of Public Health, Louisiana State University Health-New Orleans, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7998-4759","authenticated-orcid":false,"given":"Jaeil","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Georgetown University, Washington, DC 20057, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddhi","family":"Patil","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengdi","family":"Wen","sequence":"additional","affiliation":[{"name":"Epidemiology and Population Health Program, Louisiana Tumor Registry, School of Public Health, Louisiana State University Health-New Orleans, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9449-2479","authenticated-orcid":false,"given":"Muhammed","family":"Jawla","sequence":"additional","affiliation":[{"name":"Epidemiology and Population Health Program, Louisiana Tumor Registry, School of Public Health, Louisiana State University Health-New Orleans, New Orleans, LA 70112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batsirai","family":"Mabvakure","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura S.","family":"Rozek","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. 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