Association between colonic screening, subject characteristics, and stage of colorectal cancer.
OBJECTIVE
Colorectal cancer remains a significant cause of mortality and morbidity in North America. Colorectal cancer survival is highly dependent on stage at diagnosis, therefore it is important to identify factors related to stage. This study evaluated the association between subject factors (e.g., colonic screening, family history) and stage of colorectal cancer at diagnosis.


METHODS
Population-based colorectal cancer cases recruited by the Ontario Familial Colon Cancer Registry between 1997 and 1999 were staged according to the tumor-nodal-metastasis (TNM) staging system and classified as early (TNM I/II) or late (TNM III/IV) stage. Epidemiologic information and stage was available for 768 cases. Multivariate logistic regression was used to obtain odds ratios (OR) estimates.


RESULTS
Having had screening endoscopy reduced the risk of late stage diagnosis (OR = 0.46, 95% CI 0.22-0.98). Being older (>45 yr) was associated with a reduced risk of late stage cancer (OR = 0.36, 95% CI 0.18-0.74), as was having a first degree relative with colorectal cancer (OR =0.66, 95% CI 0.46-0.95). Rural residence (OR = 1.48, 95% CI 1.01-2.17) and non-white ethnicity (OR = 3.34, 95% CI 1.20-9.36) were associated with an increased risk of late stage cancer.


CONCLUSIONS
Several factors are independently associated with late stage colorectal cancer. Colorectal cancer screening awareness and education programs need to consider targeting persons most likely to present with late stage colorectal cancer.
Fazio
Laura
L
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
Cotterchio
Michelle
M
Manno
Michael
M
McLaughlin
John
J
Gallinger
Steven
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D003113:Colonoscopy; D005006:Ethnicity; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009864:Ontario; D011159:Population Surveillance; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health