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African-Americans have worse Prognosis at
Colorectal Cancer Diagnosis
Newswise — African-American patients with
colorectal were more likely to present with
worse pathological features at diagnosis and
to have a worse five-year survival rate
compared to Caucasian patients, according to
a study conducted by researchers at Thomas
Jefferson University.
The results are being presented at the 2009
American Society of Clinical Oncology (ASCO)
Gastrointestinal Cancers Symposium.
The
study was led by Edith Mitchell, M.D., a
clinical professor in the Department of
Medical Oncology at Jefferson Medical
College of Thomas Jefferson University.
Dr. Mitchell is also associate director of
Diversity Programs for the Kimmel Cancer
Center at Jefferson.
“One possible explanation could be the
socioeconomic factors that are often
associated with African-American patients,”
Dr. Mitchell said.
“For example, research has shown that
African-Americans are less likely than
Caucasian patients to have health insurance,
and thus they may not receive the screening
necessary to detect colorectal cancer at an
earlier stage.”
Dr. Mitchell and colleagues obtained data
from the tumor registry of Thomas Jefferson
University Hospital on 2,500 patients
treated for colorectal cancer from 1988 to
2007.
They compared those data with data obtained
from the National Cancer Institute’s
Surveillance, Epidemiology and End Results
(SEER) database on 244,701 patients with
colorectal cancer treated from 1988 to 2005.
The researchers collected data on location,
stage and histologic grade of the cancer.
In both patient groups, more
African-American patients presented with
advanced disease (defined as stage III or
stage IV) at diagnosis. African-American
patients were also more likely to have
proximal – on the right side of the colon –
disease.
Among patients diagnosed with early-stage
disease, the risk for nodal involvement was
greater in African-American patients.
African-American patients also had a worse
five-year survival, both overall and when
stratified by cancer stage.
“Right now, we cannot definitely explain why
there are such differences between the
African-American and the Caucasian
patients,” Dr. Mitchell said.
“We need to do more studies on prognostic
factors related to tumor biology, molecular
markers and genetics to account for the
racial disparities.”
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