title: Association between colonic screening, subject characteristics, and stage of colorectal cancer.
abstract: 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.
authors.affiliation: Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Fazio
authors.forename: Michelle
authors.initials: M
authors.lastname: Cotterchio
authors.forename: Michael
authors.initials: M
authors.lastname: Manno
authors.forename: John
authors.initials: J
authors.lastname: McLaughlin
authors.forename: Steven
authors.initials: S
authors.lastname: Gallinger
mesh_terms: 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