title: Colorectal cancer in Hispanics: a population at risk for earlier onset, advanced disease, and decreased survival.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
authors.forename: Brad H
authors.initials: BH
authors.lastname: Pollock
authors.forename: Jennifer
authors.initials: J
authors.lastname: Miranda
authors.forename: Adrian
authors.initials: A
authors.lastname: Wong
authors.forename: Francis E
authors.initials: FE
authors.lastname: Sharkey
authors.forename: Dennis L
authors.initials: DL
authors.lastname: Rousseau
authors.forename: Charles R
authors.initials: CR
authors.lastname: Thomas
authors.forename: Morton S
authors.initials: MS
authors.lastname: Kahlenberg
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000473:pathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D016019:Survival Analysis; D013781:Texas / Q000453:epidemiology