{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:03:34Z","timestamp":1791119014375,"version":"4.1.0"},"posted":{"date-parts":[[2026,6,29]]},"group-title":"Epidemiology","reference-count":28,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Cancer Institute","award":["R01CA259420"],"award-info":[{"award-number":["R01CA259420"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Colorectal cancer (CRC) disproportionately affects non-Hispanic Black (NHB) Americans compared to Non-Hispanic White (NHW), with more cases arising before age 50. Racial disparities in outcomes reflect complex interactions among healthcare access, socioeconomic factors, and structural racism, yet analyses linking individual-level data for these factors to survival remain limited.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We examined overall and CRC-specific survival among NHB and NHW patients diagnosed between 2013 and 2022 enrolled in the Disparities and Cancer Epidemiology (DANCE) cohort, a population-based study of CRC in metropolitan Detroit and Louisiana. Multivariable Cox regression and competing-risks models were used to assess the roles of race, age of onset, neighborhood deprivation, and stage on survival outcomes.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1,019 CRC cases (57% NHB, 43% NHW), NHB patients were more likely to reside in high-deprivation neighborhoods, report lower household incomes, and present with right-sided tumors, though stage at diagnosis did not differ by race. In multivariable analysis, stage was the strongest predictor of survival, while neighborhood deprivation (per 10-unit ADI increase: HR = 1.14) was independently associated with worse survival; NHB race was not significantly associated with survival after adjustment. Younger age at diagnosis was associated with a survival advantage in regional-stage disease but paradoxically with worse survival in distant-stage disease, and higher deprivation predicted worse survival in both local and distant but not regional stage.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our study shows that socioeconomic factors, as measured by ADI and household income, accounts for some, but not all, of the disparities in survival between NHB and NHW CRC cases.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.06.24.26356439","type":"posted-content","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T16:30:17Z","timestamp":1782750617000},"source":"Crossref","is-referenced-by-count":2,"title":["Race and Socioeconomic Status Impact Survival from Early and Late-Onset Colorectal Cancer"],"prefix":"10.64898","author":[{"given":"Kristen","family":"Purrington","sequence":"first","affiliation":[{"name":"School of Medicine, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Chin","family":"Hsieh","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":"Siddhi","family":"Patil","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, 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":"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":"Rui","family":"Zhang","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":"Julie J.","family":"Ruterbusch","sequence":"additional","affiliation":[{"name":"School of Medicine, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Samdani","sequence":"additional","affiliation":[{"name":"Department of Pathology, MedStar Georgetown University Hospital, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Lee","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Wenzlaff","sequence":"additional","affiliation":[{"name":"School of Medicine, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Latif","sequence":"additional","affiliation":[{"name":"Milken Institute of Public Health, George Washington University, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiranjeev","family":"Dash","sequence":"additional","affiliation":[{"name":"Georgetown-Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, 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