title: Colorectal cancer incidence in the United States, 1999-2004 : an updated analysis of data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program.
abstract: BACKGROUND
  : By using recent national cancer surveillance data, the authors investigated colorectal cancer (CRC) incidence by subpopulation to inform the discussion of demographic-based CRC guidelines.
  
  
  METHODS
  : Data included CRC incidence (1999-2004) from the combined National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program databases. Incidence rates (age-specific and age-adjusted to the 2000 US standard population) were reported among individuals ages 40 to 44 years, 45 to 49 years, 50 to 64 years, and > or =65 years by sex, subsite, disease stage, race, and ethnicity. Rate ratios (RR) and rate differences (RD) were calculated to compare CRC rates in different subpopulations.
  
  
  RESULTS
  : Incidence rates were greater among men compared with women and among blacks compared with whites and other races. Incidence rates among Asians/Pacific Islanders (APIs), American Indians/Alaska Natives (AI/ANs), and Hispanics consistently were lower than among whites and non-Hispanics. Sex disparities were greatest in the population aged > or =65 years, whereas racial disparities were more pronounced in the population aged <65 years. Although the RD between blacks and whites diminished at older ages, the RD between APIs and whites, between AI/ANs and whites, and between non-Hispanics and Hispanics increased with increasing age. By subsite, blacks had the highest incidence rates compared with whites and other races in the proximal and distal colon; the reverse was true in the rectum. By stage, whites had higher incidence rates than blacks and other races for localized and regional disease; for distant and unstaged disease, blacks had higher incidence rates than whites.
  
  
  CONCLUSIONS
  : The current findings suggested differences that can be considered in formulating targeted screening and other public health strategies to reduce disparities in CRC incidence in the United States. Cancer 2009. Published 2009 by the American Cancer Society.
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Center for Disease Control and Prevention, Atlanta, Georgia, USA. srim@cdc.gov
authors.forename: Sun Hee
authors.initials: SH
authors.lastname: Rim
authors.forename: Laura
authors.initials: L
authors.lastname: Seeff
authors.forename: Faruque
authors.initials: F
authors.lastname: Ahmed
authors.forename: Jessica B
authors.initials: JB
authors.lastname: King
authors.forename: Steven S
authors.initials: SS
authors.lastname: Coughlin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012042:Registries; D018426:SEER Program; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology