Arshad Hafiz Muhammad Sharjeel, Kabir Christopher, Tetangco Eula, Shah Natahsa, Raddawi Hareth
Department of Internal Medicine, University of Illinois at Chicago/Advocate Christ Medical Center, 4440 W 95th Street, NO 131, Oak Lawn, IL, USA.
Department of Research, Advocate Christ Medical Center, Oak Lawn, IL, USA.
Dig Dis Sci. 2017 Sep;62(9):2526-2531. doi: 10.1007/s10620-017-4653-4. Epub 2017 Jun 19.
Recently published data indicate increasing incidence of colorectal adenocarcinoma (CRC) in young-onset (<50 years) patients.
This study examines racial disparities in presentation and survival times among non-Hispanic Blacks (NHB) and Hispanics compared with non-Hispanic Whites (NHW).
A retrospective single-center cohort study was conducted from 2004 through 2014 using 96 patient medical charts with a diagnosis of young-onset CRC. Age, gender, primary site, and histological stage at the time of diagnosis were assessed for survival probabilities by racial group over a minimum follow-up period of 5 years.
Among subjects with CRC diagnosis before 50 years of age, the majority of subjects were between 40 and 50 years, with CRC presentation occurring among this age group for 51 (79.7%) of NHW, 18 (81.8%) of NHB, and 5 (50.0%) of Hispanics. The majority of all patients presented with advanced stages of CRC (31.3% with stage III and 27.1% with stage IV). NHB exhibited statistically significantly worse survival compared to NHW (adjusted hazard ratio for death = 2.09; 95% confidence interval 1.14-3.84; P = 0.02). A possible trend of worse survival was identified for Hispanics compared to NHW, but this group was low in numbers and results were not statistically significant.
Disparities between racial groups among young-onset CRC cases were identified in overall survival and reflect growing concern in rising incidence and differentiated care management.
最近公布的数据表明，年轻发病（<50岁）患者的结直肠癌（CRC）发病率在上升。
本研究调查了非西班牙裔黑人（NHB）和西班牙裔与非西班牙裔白人（NHW）相比，在临床表现和生存时间上的种族差异。
2004年至2014年进行了一项回顾性单中心队列研究，使用96份诊断为年轻发病CRC的患者病历。在至少5年的随访期内，按种族分组评估年龄、性别、原发部位和诊断时的组织学分期的生存概率。
在50岁前诊断为CRC的受试者中，大多数受试者年龄在40至50岁之间，该年龄组中CRC的发生率为：NHW中有51例（79.7%），NHB中有18例（81.8%），西班牙裔中有5例（50.0%）。所有患者中大多数呈现CRC晚期（III期为31.3%，IV期为27.1%）。与NHW相比，NHB的生存率在统计学上显著更差（死亡调整风险比=2.09；95%置信区间1.14 - 3.84；P = 0.02）。与NHW相比，西班牙裔的生存率有更差的可能趋势，但该组数量较少，结果无统计学意义。
年轻发病CRC病例的种族群体之间在总生存方面存在差异，这反映了对发病率上升和差异化护理管理的日益关注。
