title: Colorectal cancer in southern Israel: Comparison between Bedouin Arab and Jewish patients.
abstract: OBJECTIVE
  Colorectal cancer (CRC) is the second most common malignancy and the third leading cause of cancer deaths in Israel; it is less common among the Arab than the Jewish population. This study compares the clinico-pathologic features, treatment, and prognosis between Bedouin-Arab (BA) and Jewish CRC patients treated at our medical centre.
  
  
  METHODS
  The medical records of 56 BA patients with CRC were compared retrospectively to 115 Jewish patients. Collected data included age, gender, history of smoking, family history of cancer, presenting symptoms, laboratory tests, previous malignancy, tumor characteristics, surgery type, stoma formation and closure, types of adjuvant treatment, and outcome.
  
  
  RESULTS
  BA patients were younger (mean age 68 versus 57 years, p < 0.001), showed a higher incidence in females (p = 0.045), and had a lower frequency of a family history of cancer (p = 0.005) compared to Jewish patients. BA patients had a higher presentation of rectal bleeding and a lower rate of anemia at tumor diagnosis (p = 0.05 and p = 0.004, respectively) with a more distal location of the tumor (p = 0.003). BA patients more often received chemotherapy and radiotherapy (p = 0.02 and p = 0.04, respectively). Disease-free survival was shorter among BA patients (p = 0.023); overall survival was similar in both groups.
  
  
  CONCLUSIONS
  CRC in BAs is characterized by a higher proportion of female, younger age, and higher proportion of distal location compared to Jewish patients. These differences in biology may be related to differences in past lifestyles and diet of BA compared to Jewish patients, and are expected to decrease in the following years as the BA population continues to undergo "westernization" changes.
authors.affiliation: Departments of Surgery, Soroka University Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Michael
authors.initials: M
authors.lastname: Smirnov
authors.affiliation: Departments of Oncology, Soroka University Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Irina
authors.initials: I
authors.lastname: Lazarev
authors.affiliation: Departments of Surgery, Soroka University Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Zvi Howard
authors.initials: ZH
authors.lastname: Perry
authors.affiliation: Departments of Oncology, Soroka University Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ariad
authors.affiliation: Departments of Surgery, Soroka University Medical Center and Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: borkirsh@bgu.ac.il.
authors.forename: Boris
authors.initials: B
authors.lastname: Kirshtein
mesh_terms: D000328:Adult; D000368:Aged; D018912:Arabs; D015179:Colorectal Neoplasms / Q000208:ethnology* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D007585:Jews; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
keywords: Bedouin-Arabs; Clinico-pathological presentation; Colorectal cancer; Jews; Outcome; Prognosis