title: Predictors of delayed-stage colorectal cancer: are we neglecting critical demographic information?
abstract: OBJECTIVE
  We sought to distinguish roles of demographic variables and bowel segments as predictors of delayed versus early stage colorectal cancer in California.
  
  
  METHODS
  Demographic and anatomic variables for 66,806 colorectal cancers were extracted from the California Cancer Registry for 2004-2008 and analyzed using logistic regression as delayed versus early stage.
  
  
  RESULTS
  Odds ratios (OR) for binary stage categories comparing age <40 (OR=2.58; 95% CI=2.26-2.94), 40-49 (1.71; 95%=1.60-1.83) and 75+ (1.05; 1.02-1.09) relative to 50-74 years were computed. Compared with non-Hispanic whites, ORs for stage categories were: 1.05; 0.99-1.13 (non-Hispanic blacks), 1.08; 1.02-1.13 (Hispanics), and 1.05; 1.00-1.10 (Asian/others). Females had higher odds of delayed diagnosis (1.09; 1.06-1.13) than males. Descending ORs were measured for successively lower to highest socioeconomic status (SES) quintiles (OR 4:5=1.08; 1.03-1.14, OR 3:5=1.13; 1.08-1.19, OR 2:5=1.18; 1.12- 1.24, and OR 1:5=1.21; 1.14-1.28).
  
  
  CONCLUSIONS
  Younger and older than age 50-74; females; Hispanic ethnicity; bowel segment contrasts (right/left, proximal/distal, cecum plus appendix/distal), and lower SES were independent predictors of delayed diagnosis. Low SES was the most robust predictor of delayed diagnosis, independent of other covariates. Approximately 77% of delayed diagnoses were in non-Hispanic whites and Asian/others. These findings illustrate the value of a community SES index for targeting egalitarian colorectal cancer screening.
authors: Department of Epidemiology & Biostatistics, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA. john.w.morgan@att.net
authors: John W
authors: JW
authors: Morgan
authors: Myung Mi
authors: MM
authors: Cho
authors: Christine D
authors: CD
authors: Guenzi
authors: Christian
authors: C
authors: Jackson
authors: Arvind
authors: A
authors: Mathur
authors: Zuhair
authors: Z
authors: Natto
authors: Kevork
authors: K
authors: Kazanjian
authors: Hoan
authors: H
authors: Tran
authors: David
authors: D
authors: Shavlik
authors: Sharon S
authors: SS
authors: Lum
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015179:Colorectal Neoplasms / Q000208:ethnology / Q000401:mortality / Q000473:pathology*; D016001:Confidence Intervals; D003710:Demography; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D044469:Racial Groups; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D013997:Time Factors; D055815:Young Adult