Stefanidis Dimitrios, Pollock Brad H, Miranda Jennifer, Wong Adrian, Sharkey Francis E, Rousseau Dennis L, Thomas Charles R, Kahlenberg Morton S
Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Am J Clin Oncol. 2006 Apr;29(2):123-6. doi: 10.1097/01.coc.0000199918.31226.f8.
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.
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.
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.
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.
尽管在过去十年中结直肠癌（CRC）的发病率和死亡率略有下降，但不同种族之间仍存在显著差异。我们的目的是在一个主要服务于西班牙裔人群的三级大学中心，研究结直肠癌在发病、临床表现和预后方面的种族差异。
对肿瘤登记处前瞻性收集的1985年至2001年期间诊断为结直肠癌患者的数据进行检查。评估诊断时的年龄、就诊方式、性别、肿瘤位置、种族、TNM分期和生存率，并寻找种族差异。
回顾了453例结直肠癌患者的记录。其中296例（65%）为西班牙裔，112例（25%）为非西班牙裔白人，37例（8%）为非裔美国人，8例（2%）为其他或不明种族。与非西班牙裔白人相比，西班牙裔患者就诊时年龄更小（分别为58.5±14岁和53.6±12.73岁；P<0.01），IV期疾病的发病率显著更高（分别为19%和32%；P = 0.02）。他们的年龄调整生存率显著更低（<55岁患者的中位生存期分别为92个月和>55岁患者为77个月，而非<55岁患者为48个月和>55岁患者为48个月；调整后的对数秩检验P = 0.045）。在肿瘤位置、就诊方式或接受的辅助治疗方面没有差异。
我们服务区域内的西班牙裔结直肠癌患者就诊时年龄更小，转移性疾病更多，生存率低于非西班牙裔白人。可能需要为西班牙裔修改筛查标准和治疗模式。
