Living in areas of persistent poverty is associated with poorer outcomes across multiple cancers—but the mechanisms behind this disparity are less well understood. A new cohort study published in JAMA Network Open sheds light on key factors that may help explain increased mortality in patients with colorectal cancer (CRC).
A retrospective cohort study of 5,028 patients with newly diagnosed colorectal cancer in Arkansas (USA) evaluated factors that may help explain the association between living in persistent poverty areas and overall survival.
The key findings:
- Patients living in persistent poverty areas had a higher risk of death compared with those in other areas (HR 1.17)
- Three factors contributed to this increased mortality risk:
- Stage at diagnosis (33.7%)
- Lower likelihood of receiving surgery (29.3%)
- Type of health insurance (13.8%)
- Patients in persistent poverty areas were more likely to present with advanced disease and less likely to undergo surgery
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Clinical implications:
- Later stage at diagnosis highlights gaps in screening and early detection
- Differences in surgical treatment suggest barriers beyond clinical eligibility
- Insurance status remains an important determinant of outcomes
- Addressing these factors may help reduce disparities in colorectal cancer survival
These findings suggest that disparities in colorectal cancer outcomes are driven less by biology than by access to timely diagnosis and treatment. Targeted efforts to improve screening uptake and equitable access to surgical care may be key to narrowing these gaps.
Paper: Schootman M, Li C, Peng C, et al. Poverty and Mortality Risk in Patients With Colorectal Cancer. JAMA Netw Open. 2026;9(4):e266303. Access online here.
