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Colorectal Cancer in Hispanics: A Population at Risk for Earlier Onset, Advanced Disease, and Decreased Survival

Stefanidis, Dimitrios MD, PhD*; Pollock, Brad H. MPH, PhD; Miranda, Jennifer BS; Wong, Adrian BS; Sharkey, Francis E. MD§; Rousseau, Dennis L. MD, PhD; Thomas, Charles R. Jr MD; Kahlenberg, Morton S. MD

American Journal of Clinical Oncology: April 2006 - Volume 29 - Issue 2 - p 123-126
doi: 10.1097/01.coc.0000199918.31226.f8
Original Article

Background: While colorectal cancer (CRC) incidence and mortality rates have declined slightly over the past decade, there remain marked differences by ethnicity. Our aim was to investigate ethnic differences in occurrence, clinical presentation and outcome of CRC at a tertiary university center that serves a predominantly Hispanic population.

Methods: Prospectively collected data from the tumor registry on patients diagnosed with colorectal cancer from 1985 through 2001 was examined. Age at diagnosis, mode of presentation, sex, tumor location, ethnicity, TNM stage, and survivals were assessed and ethnic differences were sought.

Results: Records from 453 patients with CRC were reviewed. There were 296 (65%) patients that were Hispanics, 112 (25%) non-Hispanic Whites, 37 (8%) African Americans, and 8 (2%) of other or unknown ethnicity. Compared with non-Hispanic Whites, Hispanics presented at a younger age (58.5 ± 14 versus 53.6 ± 12.73, respectively; P < 0.01), with a significantly greater incidence of stage IV disease (19% versus 32%, respectively; P = 0.02). They had significantly poorer age-adjusted survival (median survival of 92 months for <55 years and 77 months for >55 years versus 48 months for <55 years and 48 months for >55 years, respectively; adjusted log rank P = 0.045). There were no differences in tumor location, mode of presentation or adjuvant treatment received.

Conclusions: Hispanic patients with CRC in our catchment area present at a younger age with more metastatic disease and have a poorer survival than non-Hispanic Whites. Modification of screening criteria and treatment paradigms may be required for Hispanics.

From the *Department of Surgery, Carolinas Medical Center, Charlotte, NC; †Department of Surgery, Division of Surgical Oncology, ‡Center for Epidemiology and Biostatistics, and §Department of Pathology, The University of Texas Health Science Center at San Antonio, San Antonio, TX; and ¶Department of Radiation Medicine, Oregon Health and Science University, Portland, OR.

Presented at the 2004 ASCO Gastrointestinal Cancers Symposium. Current Status and Future Directions for Prevention and Management in San Francisco, CA; January 2004.

Reprints: Morton Kahlenberg, MD, FACS, Associate Professor of Surgery, Chief, Division of Surgical Oncology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900. E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.