title: Colorectal Cancer Trends in California and the Need for Greater Screening of Hispanic Men.
abstract: Colorectal cancer (CRC) incidence and mortality rates have decreased dramatically since 1990, both nationally and in California, except among Hispanic men. This study examined trends in CRC incidence, mortality, and survival to determine likely contributing factors for the differential trends between Hispanic and non-Hispanic white men in California.
  
  
  
  California Cancer Registry data were used to identify 23,157 Hispanic and 114,944 white men diagnosed with CRC between 1990 and 2012. Joinpoint trends in incidence, mortality, and 5-year relative survival were examined by age, stage at diagnosis, and tumor location. Data used in the study were extracted from the California Cancer Registry database and analyzed in 2015.
  
  
  
  Both incidence and mortality rates decreased substantially among white men between 1990 and 2012, but no corresponding decrease was observed among Hispanic men. Both groups experienced similar trends in survival and stage at diagnosis over time. White men had greater declines in CRC incidence and mortality in all age groups, particularly those aged >50 years. Hispanic men had a significantly higher proportion (65%) of tumors in the distal colon than white men (59%).
  
  
  
  CRC incidence and mortality rates have decreased among white men since 1990, but not among Hispanic men. Results from this study suggest lower screening rates may be an important reason why CRC rates in California did not decline in Hispanic men. Effective strategies aimed at both Hispanics and their healthcare providers are needed to increase CRC screening among Hispanic men and reduce their CRC burden.
authors.affiliation: California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Martinsen
authors.affiliation: California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California. Electronic address: cmorris@ucdavis.edu.
authors.forename: Cyllene R
authors.initials: CR
authors.lastname: Morris
authors.affiliation: Epidemiology and Biostatistics, School of Community Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada.
authors.forename: Paulo S
authors.initials: PS
authors.lastname: Pinheiro
authors.affiliation: California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California.
authors.forename: Arti
authors.initials: A
authors.lastname: Parikh-Patel
authors.affiliation: California Cancer Reporting and Epidemiologic Surveillance (CalCARES) Program, Institute for Population Health Improvement, University of California Davis Health System, Sacramento, California.
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Kizer
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D012189:Retrospective Studies; D044465:White People / Q000706:statistics & numerical data