Exploring the role of marital status on survival and stage at diagnosis in early-onset colorectal cancer by race/ethnicity.

We examined the relationship of marital status on cause-specific survival and late-stage at diagnosis for early-onset colorecta cancer (EO-CRC), overall and within five racial/ethnic groups (non-Hispanic White [NHW], non-Hispanic Black [NHB], American Indian/Alaskan Native [AI/AN], Asian/ Pacific Islanders [PI], or Hispanic). We conducted a retrospective cohort analysis using data from 2006 to 2015 Surveillance, Epidemiology, and End Results Program. The Kaplan-Meier method, multivariable Cox proportional hazards regression, and logistical regression models were performed. Among 58,884 participants, the lower five-year survival rate was 66.4% for EO-CRC patients who were unmarried (p-value < 0.001). The 5-year survival rate was the lowest for NHB patients (64.9% vs. 69.7% for AI/AN, 70.1% for Hispanic, 72.2% for Asian/PI, and 72.8% for NHW). Unmarried NHW (hazard ratio [HR], 1.25; 95% CI, 1.19-1.30), NHB (HR, 1.28; 95% CI, 1.18-1.39), Asian/PI (HR, 1.17; 95% CI, 1.03-1.32), and Hispanic patients (HR, 1.10; 95% CI, 1.01-1.19) were more likely to die from CRC than those were married. Further, unmarried NHW (OR, 1.16; 95% CI, 1.09-1.22), NHB (OR, 1.23; 95% CI, 1.10-1.38), and Asian/PI patients (OR, 1.18; 95% CI, 1.00-1.38) had a risk for a later stage at diagnosis for CRC. We observed lowest five-year survival rate among unmarried patients. Culturally sensitive interventions aimed at improving EO-CRC survival may benefit individuals across all racial groups. Such efforts can be strengthened by enhancing social support networks and increasing CRC risk awareness as well as equitable access to care, particularly for NHW, NHB, and Asian/PI populations.