Colorectal cancer (CRC) is the third most common cancer among both men and women in the U.S. with approximately 150,000 new cases expected in 2003. While the incidence and mortality rate of CRC has declined among Caucasians, incidence and mortality among African-Americans, particularly men, has increased. These racial differences are poorly understood. Several studies point to age, advanced stage of disease at diagnosis, inaccurate staging, and differences in treatment between racial groups as being possible factors.
A team of researchers led by Dr. Upender Manne of the University of Alabama-Birmingham investigated the reasons for racial differences in CRC survival between 199 African-Americans and 292 non-Hispanic Caucasians with CRC who underwent surgical treatment between 1981 and 1993.
African-Americans were 1.67 times more likely die within five years and 1.52 times more likely to die within ten years after surgical treatment for CRC compared to Caucasians. These differences remained even after adjusting for colon cancer stage and other confounding variables. Racial differences were most pronounced in patients with stage II disease; African-Americans with stage II disease were at 2.53 times greater risk of death within five years and 1.82 times greater risk of death within ten years post-surgery. There were no racial differences in survival rates among patients with rectal cancer.
These findings suggest that factors related to the tumor, such as genetic differences or other biological properties, may contribute to racial disparities in survival of patients with colon cancer.
Article: "Postsurgical Disparity in Survival between African Americans and Caucasians with Colonic Adenocarcinoma," Dominik Alexander, Chakrapani Chatla, Ellen Funkhouser, Sreelatha Meleth, William E. Grizzle, Upender Manne, CANCER; Published Online: May 24, 2004 (DOI: 10.1002/cncr.20337); Print Issue Date: July 1, 2004.