Demographic Influence on Colorectal Cancer
Abstracts
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The purpose of this study was to examine the demographic pattern of colorectal cancer, to define race or gender-based differences in colorectal cancer, and to determine variability of care based on socioeconomic status. Consecutive cases of colorectal cancer recorded in our Cancer Registry from 1997 to 2000 were reviewed. Significance (p<0.05) was determined by univariate analysis using chi-square test to compare categorical variables. There were 178 patients (M:F, 83:95), 76% caucasian and 24% African American. Right-sided cancer was the most frequent site (47%) regardless of age, race, or gender. The mean age (years) of African Americans was significantly (p=0.02) younger than caucasians. There was a higher percentage of African American men and women diagnosed with cancer before the age of 50 years compared to caucasians. African Americans also presented with a greater number of symptoms when compared to caucasians (p=0.007). There was no race-related difference in tumor characteristics. Although African Americans had a significantly (p<0.007) lower annual income and rate of private insurance, both groups were comparable in early cancer detection by screening and in receiving adjuvant therapy. The mean length of follow-up was significantly (p=0.03) shorter for African Americans. Female gender, regardless of race, and rectosigmoid cancers were risk factors (p<0.04) associated with late (stage 4) disease at presentation. Socioeconomic variables (p>0.30) did not influence stage of disease at presentation or detection by screening. There is a race-related difference in age and extent of symptoms at presentation in colorectal cancer. Socioeconomic factors do not lead to significant variability of care in colorectal cancer at our institution. Efforts are required to achieve earlier diagnosis in females and in rectosigmoid cancer. |
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