Colon cancer in blacks: a disease with a worsening prognosis.

Despite the fact that a significant national effort has been made over the past 10 years to improve the early detection and treatment of colorectal cancer, blacks have not had any change in their prognosis compared to whites, and their survival rate appears to be independent of stage at the time of diagnosis. The disease incidence is practically the same for both races, 49 per 100,000. We reviewed all patients with colorectal cancer in our Tumor Registry over a 10-year period to determine whether the experience at an all-black institution with a black patient base for much of its history would help clarify these crucial questions. There were 118 cases (73 women/45 men), and the mean age was 68 years (range: 29 to 93). The most common signs and symptoms were gross bleeding (34%) and abdominal pain (30%), with most patients presenting with a combination of symptoms. Remarkably, none were symptom-free. Of the 96 patients who were staged surgically and pathologically, 68 (71%) were beyond Duke's B staging at the time of diagnosis and surgery. The overall 5-year survival rate was 47%, significantly related to stage of disease at diagnosis (P less than .001). We concluded that blacks have not shared in the progress made in early diagnosis and treatment of colon cancer, and that special attention should be given to developing screening and surveillance methodology targeted specifically at blacks.

AIDS: knowledge and attitudes among different ethnic groups.

To study the ethnic differences in knowledge, attitudes, and beliefs about AIDS, we surveyed 161 US residents from 31 different countries. An anonymous self-administered questionnaire was developed to compile these data. The results of this survey suggest that AIDS-related knowledge is generally incomplete and there are still misconceptions about AIDS regardless of ethnicity or national origin. However, Americans and Europeans were more aware of some of the modes of contracting AIDS than were people from Asia, the Middle East, or Africa. We conclude that some ethnic and national groups are more likely to have misconceptions about AIDS than others. Therefore, additional public educational programs and activities with special outreach programs for ethnic groups in the United States must be accomplished through methods that are culturally sensitive if they are to be effective.