title: Comparative analysis of lifestyle factors, screening test use, and clinicopathologic features in association with survival among Asian Americans with colorectal cancer.
abstract: BACKGROUND
  Colorectal cancer (CRC) diagnoses and disease-specific survival (DSS) vary between ethnic groups in the United States. However, few studies have assessed differences among Asian subgroups.
  
  
  METHODS
  The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients with invasive CRC between 1988 and 2008. Differences in clinicopathologic features, and DSS rates were compared among Asian subgroups. The California Health Interview Survey was used to examine risk factors and screening patterns for CRC.
  
  
  RESULTS
  The study included 359 374 patients with 8.4% Asian. Patients in all Asian subgroups were younger (median: 68 years) at diagnosis than non-Hispanic white (NHW) patients (median: 72 years). Most Asian subgroups, except Hawaiians, had better DSS than NHW patients although Asian subgroups had more advanced disease than NHW. Indian/Pakistani patients had a higher 5-year DSS than other Asian subgroups. Obesity proportions were lower in Asian subgroups (<50.2%) than in NHW (59.8%). Vietnamese men and Korean women had the lowest proportions of CRC screening. Advance tumour stages were highly associated with worse DSS in each ethnicity group. High tumour grades were associated with worse DSS in NHW, Filipino, and Chinese. Older age at diagnosis was associated with worse DSS in most ethnicity groups except Hawaiian and Vietnamese.
  
  
  CONCLUSIONS
  Disparities exist between Asians and NHW with CRC, and among various Asian subgroups. Differences in cancer clinicopathologic features, patients' behavioural habits, lifestyle, and screening patterns may explain some differences in CRC survival observed among ethnic groups.
authors.affiliation: Department of Translational Medicine, The First Affiliated Hospital of Xian Jiaotong University, School of Medicine, Xian, China. myi@mdanderson.org
authors.forename: M
authors.initials: M
authors.lastname: Yi
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.forename: P
authors.initials: P
authors.lastname: Liu
authors.forename: G J
authors.initials: GJ
authors.lastname: Chang
authors.forename: X L
authors.initials: XL
authors.lastname: Du
authors.forename: C-Y
authors.initials: CY
authors.lastname: Hu
authors.forename: Y
authors.initials: Y
authors.lastname: Song
authors.forename: J
authors.initials: J
authors.lastname: He
authors.forename: Y
authors.initials: Y
authors.lastname: Ren
authors.forename: Y
authors.initials: Y
authors.lastname: Wei
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: K K
authors.initials: KK
authors.lastname: Hunt
authors.forename: X
authors.initials: X
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data*; D002648:Child; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000473:pathology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult