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. 2024 May 28:43:102774.
doi: 10.1016/j.pmedr.2024.102774. eCollection 2024 Jul.

Ethnic disparities in early-onset colorectal cancer incidence, screening rates and risk factors prevalence in Guam

Grazyna Badowski  1 , Rodney Teria  1 , Michelle Nagata  2 , Justin Legaspi  2 , Louis Jane B Dulana  1 , Renata Bordallo  1 , Brenda Y Hernandez  2
Affiliations

Ethnic disparities in early-onset colorectal cancer incidence, screening rates and risk factors prevalence in Guam

Grazyna Badowski et al. Prev Med Rep. .

Abstract

Objective: Colorectal cancer (CRC) is one of the four most common cancers and the third leading cause of cancer-related deaths in Guam. This study investigated CRC incidence, screening, and risk factors of early onset CRC across Guam's ethnic groups using data from the Guam Cancer Registry (1998-2020) and the Guam Behavioral Risk Factor Surveillance System (2018-2019).

Methods: Incidence rate ratios (IRRs) were calculated to compare incidence rates across different age groups stratified by sex, ethnicity, and stage. Incidence rate differences (IRDs) were used to test for significant differences across sex and ethnicity. The Pearson chi-square test was used to assess differences in CRC screening rates by age, sex, education, income, healthcare coverage, and ethnicity, and to examine ethnic group disparities in the prevalence of CRC risk factors.

Results: The steepest increase in CRC incidence was observed between the 35-39 and 40-44 age groups (IRR = 2.01; 95 % CI: 1.14-3.53) and between the 40-44 and 45-49 age groups (IRR = 1.99; 95 % CI: 1.34-2.97). CHamorus exhibited rate increases at younger ages compared to Filipinos. CRC screening prevalence and associated risk factors showed considerable variation among ethnicities.

Conclusions: Elevated early-onset CRC rates were observed for both CHamorus and the broader Guam population under 50. The findings support the new recommendation to begin screening at age 45 and efforts to increase screening in Guam.

Keywords: CRC risk factors; Cancer disparities; Colorectal cancer screening; EOCRC; Minority populations.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Colorectal Cancer Age-Specific Incidence Rates per 100,000 Population Stratified by Ethnicity (CHamorus and Filipinos) and Sex (Males and Females) in Guam Cancer Registry Among Patients Aged 35–64 Years, 1998–2020.
Fig. 2
Fig. 2
Prevalence Rates (%) of CRC Cancer Risk Factors Among Adults Aged 35–64 Stratified by Ethnicity, Behavioral Risk Factor Surveillance System Data, Guam 2019. P-values based on Chi-Square Test. (* Did not meet physical activity guidelines).
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