P0188 - Unveiling Racial Inequalities in Colon Cancer Incidence After Bariatric Surgery: Insights From the Log Rank Mantel-Cox Test

Rajmohan Rammohan, MD, Sai Greeshma Magam, MD, Melvin Joy, MD, Dilman Natt, MD, Achal Patel, MD, Tulika Saggar, MD, Abhishek Tadikonda, MD, Jiten Desai, MD, Sandra Gomez, MD, Rucha Jiyani, MD, Saher Sheikh, MD, Alexander Landsman, DO, Paul Mustacchia, MD, MBA
Nassau University Medical Center, East Meadow, NY

Introduction: Obesity, a leading modifiable risk factor for cancer in the US, often requires treatments like bariatric surgery when lifestyle changes are ineffective. This is particularly relevant for colorectal cancer (CRC), a major cause of cancer-related deaths, where rates decline after surgery but racial disparities persist. The decreased prevalence of CRC and its precursors, colorectal adenomas, post-surgery across various racial and ethnic subgroups, is an area that warrants further research

Methods: Our research performed a retrospective analysis on patients receiving bariatric surgery at our facility from 2009-2022. We collected comprehensive data, including comorbidities, insurance, surgical procedures, colonoscopy and pathology reports, and baseline characteristics, employing ICD and CPT codes for streamlining. We concentrated on post-procedure colon cancer patients, classifying them based on sex, race, and tumor location. Propensity score matching ensured effective baseline characteristic comparison. We utilized Kaplan Meier estimations to discern colon cancer onset timing among races, and the Odds ratio to identify independent factors significantly influencing the study outcome

Results: From 2009-2022, our hospital performed 960 bariatric surgeries, with 119 (12%) patients developing colorectal cancer post-procedure. The average detection time post-surgery was 47.7±23.3 months. The average age in the study group was 58.34±7.39, with 82% being female. The cohort was racially diverse: 41% African American, 20% White, 13.4% Asian, and 30% Hispanic. Hispanics (30%) exhibited the shortest cancer development time compared to other races (log-rank Mantel cox: 16.210, p=0.05). Notably, the lower income quartile (OR:1.15, P< 0.05) and lower education status (OR:2.23, P=0.025) were unique risk factors influencing cancer incidence in the Hispanic population.

Discussion: Our study highlights racial and socioeconomic disparities in colorectal cancer incidence post-bariatric surgery, with 12% of our cohort developing cancer. Disparities were most significant in Hispanic patients, who developed cancer quickest and were greatly influenced by socioeconomic factors. The findings call for targeted interventions and enhanced follow-ups, especially for higher risk populations. Future research should identify the precise factors causing these disparities and potential mitigation strategies.



Disclosures:


Rajmohan Rammohan, MD, Sai Greeshma Magam, MD, Melvin Joy, MD, Dilman Natt, MD, Achal Patel, MD, Tulika Saggar, MD, Abhishek Tadikonda, MD, Jiten Desai, MD, Sandra Gomez, MD, Rucha Jiyani, MD, Saher Sheikh, MD, Alexander Landsman, DO, Paul Mustacchia, MD, MBA. P0188 - Unveiling Racial Inequalities in Colon Cancer Incidence After Bariatric Surgery: Insights From the Log Rank Mantel-Cox Test, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.