biostudies-literatureDelNero PAmerican Cancer SocietyNCATS NIH HHSWinthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences/Arkansas Insurance Department/Arkansas Healthcare Transparency Initiative CollaborationNIH HHSArkansas Biosciences Institutee70045https://www.ebi.ac.uk/biostudies/studies/S-EPMC12466537biostudies-literatureUnknown41(3)<h4>Purpose</h4>We examined whether living in persistent poverty census tracts was associated with disparities in colorectal cancer (CRC) survival and whether the association varied between urban and rural settings.<h4>Methods</h4>Using 2013-2019 state-wide cancer registry and 2013-2021 death records data, CRC patients were classified by tract-level persistent poverty and rural/urban status. Overall and CRC-specific survival were compared using Kaplan-Meier estimation and log-rank tests. Adjusted analyses were conducted using Cox proportional hazard and Fine-Gray competing risk models.<h4>Findings</h4>During the study period, 558 (53%) of 1055 CRC patients died in persistent poverty tracts versus 3117 (45%) of 6938 patients in nonpersistent poverty tracts. Of the 3675 deaths, 2269 (61.7%) were from CRC-specific causes. In unadjusted analysis, CRC patients in persistent poverty areas had a higher risk of all-cause (HR, 95%CI: 1.28, 1.17-1.40) and CRC-specific (HR, 95% CI: 1.17, 1.04-1.31) mortality. After covariates adjustment, the relationship between persistent poverty and all-cause mortality (HR, 95% CI: 1.17, 1.06-1.29) and non-CRC-specific mortality (HR, 95% CI: 1.34, 1.15-1.57) remained significant, but CRC-specific mortality did not. In subgroup analyses, persistent poverty was associated with increased overall mortality among urban tracts (HR, 95% CI: 1.22, 1.08-1.38), but not rural tracts.<h4>Conclusions</h4>After covariates adjustment, CRC patients in persistent poverty tracts are more likely to die of all causes and non-CRC causes but not CRC-specific causes than those in nonpersistent poverty areas, suggesting that differences in CRC-specific deaths may be partly attributed to demographics, geography, tumor characteristics, and treatment.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care AssociationColorectal cancer survival disparities in persistent poverty areas.PMC12466537RSGI-23-1039245-01-HOPSUM1 TR004909UL1 TR003107Schootman MLaryea JLi CSaini MPeng CDelNero PHallgren EfalseColorectal cancer survival disparities in persistent poverty areas.<h4>Purpose</h4>We examined whether living in persistent poverty census tracts was associated with disparities in colorectal cancer (CRC) survival and whether the association varied between urban and rural settings.<h4>Methods</h4>Using 2013-2019 state-wide cancer registry and 2013-2021 death records data, CRC patients were classified by tract-level persistent poverty and rural/urban status. Overall and CRC-specific survival were compared using Kaplan-Meier estimation and log-rank tests. Adjusted analyses were conducted using Cox proportional hazard and Fine-Gray competing risk models.<h4>Findings</h4>During the study period, 558 (53%) of 1055 CRC patients died in persistent poverty tracts versus 3117 (45%) of 6938 patients in nonpersistent poverty tracts. Of the 3675 deaths, 2269 (61.7%) were from CRC-specific causes. In unadjusted analysis, CRC patients in persistent poverty areas had a higher risk of all-cause (HR, 95%CI: 1.28, 1.17-1.40) and CRC-specific (HR, 95% CI: 1.17, 1.04-1.31) mortality. After covariates adjustment, the relationship between persistent poverty and all-cause mortality (HR, 95% CI: 1.17, 1.06-1.29) and non-CRC-specific mortality (HR, 95% CI: 1.34, 1.15-1.57) remained significant, but CRC-specific mortality did not. In subgroup analyses, persistent poverty was associated with increased overall mortality among urban tracts (HR, 95% CI: 1.22, 1.08-1.38), but not rural tracts.<h4>Conclusions</h4>After covariates adjustment, CRC patients in persistent poverty tracts are more likely to die of all causes and non-CRC causes but not CRC-specific causes than those in nonpersistent poverty areas, suggesting that differences in CRC-specific deaths may be partly attributed to demographics, geography, tumor characteristics, and treatment.2025-01-01T00:00:00Z2025 Jun2026-06-03T21:13:19.91Z2026-05-01T03:10:42.19ZS-EPMC124665374062955410.1111/jrh.70045