Colorectal cancer in a multi-ethnic urban group: its anatomical and age profile.

PURPOSE: To determine the age of presentation and anatomical distribution of colorectal cancer in an urban multi-ethnic group. PATIENTS AND METHODS: Patients with colorectal adenocarcinoma from 1976-1995 in the tumor registry file of a major hospital in New York City's borough of Manhattan were identified. The charts of 688 patients were reviewed and the location of the cancer, ethnicity, and age at diagnosis were recorded. The tumors were classified as: right cancers (RC); from the cecum, to and including the hepatic flexure, transverse (Trans); left cancers (LC): from the splenic flexure down to and including the sigmoid colon, rectum (Rec); rectosigmoid and rectal lesions; and colorectal lesions without known locations (CA). Patients were classified from self identification, place of birth, or race as: Asians (AS); blacks (BL); Hispanics (HI); and white (WH). An ANOVA test, and a Schefee post hoc test were used to compare the mean ages. While a chi2 and a fully saturated log-linear model compared the proportions. RESULTS: We could not identify the ethnicity of three patients, and they were not included in the analysis. There were 295 women and 390 men, with a mean age of 66.6 years and 65.0 years, respectively. The overall mean age was 65.7 years. The ethnicity of the patients were: AS = 102, BL = 98, HI = 189, and WH = 296. The mean ages for the different groups were: AS = 59.9 years, BL = 63.5 years, HI = 60.4 years, and WH = 71.7 years. The age difference was significant (P < 0.05), when comparing WH versus each other group. The regional distribution of the individual groups was: AS, RC = 28, Trans = 3, LC = 31, Rec = 37, CA = 3; BL, RC = 40, Trans = 2, LC = 33, Rec = 22, CA = 1; HI, RC = 45, Trans = 3, LC = 71, Rec = 61, CA = 9; and WH, RC = 76, Trans = 19, LC = 95, Rec = 89, CA = 17. The interethnical regional distribution of the cancers was significantly different (P < 0.05). Blacks had a greater presentation of right-sided lesions than expected, and whites had less Rec and RC lesions than expected. CONCLUSIONS: Minority Americans presented with colorectal cancer at a significantly earlier age than WH Americans. Blacks had a high frequency of proximal lesions, and Caucasian Americans had low presentation of RC and Rec lesions. These findings may prove helpful in deciding when to begin screening for colorectal cancer among the different ethnic groups, and what modalities to apply given the differences in anatomical distribution of this cancer.

The anatomic distribution of colorectal cancer in a New York City Puerto Rican group

Studies have attempted to define the anatomic distribution of colorectal cancer in some black and white groups of the U.S. However, little, if any research has looked at the regional distribution of colorectal cancer in an American Hispanic, especially Puerto Rican, group. This study attempts to provide some insight into the subsegmental distribution of colorectal cancer in this group of the American population which has a heavy concentration of people in many major U.S. cities. We retrospectively reviewed the charts of Puerto Rican patients who had colorectal adenocarcinoma and were on the files of the tumor registries of two principal teaching hospitals of a New York City medical school from 1976-95, and collected the age and location of the cancers. Patients were self identified as being of Puerto Rican descent. Right colon cancers were from the cecum up to the hepatic flexure, left from the splenic flexure down to the sigmoid colon, rectal which included rectosigmoid, transverse and cancers of unknown locations. The latter were not included in the anatomic analysis since the location was not known. There were eleven of these patients. The anatomic analysis was of 134 patients. There were 67 women, and 78 men with a mean age of 60.3 years, and 63.7 years respectively with an overall mean age of 62.2 years. The anatomic distribution of the cancers were as follows: right colon cancer represented 22.4 or 30/134, transverse lesions equaled 1.5 or 2/134, left cancers were found in 38.0 or 51/134, rectal malignancies equaled 38.0 or 51/134. Previously, it has been shown that the presentation of right sided colorectal cancer in white and black Americans is greater than the 22.4 seen in the Puerto Rican group of this study. However, these previous groups have been found to have 50 of cancers located distal to the splenic flexure, similar to the Puerto Ricans in this study. The average age of Puerto Ricans presenting with colorectal cancer compared to the average age of the general population may be different. Screening techniques for colorectal cancer may be adequate for detecting colorectal cancer in Puerto Ricans, however if they are indeed presenting at a relatively early age, the techniques may need to be applied earlier in comparison to the general American population. Further study is needed to see if the age of presentation is indeed as early as suggested by the present study

Anatomic, age, and sex distribution of colorectal cancer in a New York City Hispanic population.

This study was undertaken to examine the regional distribution of colorectal cancer, the age of presentation for different subsite locations of the disease and whether there is any intersex difference in frequency of the disease, in New York City Hispanics. The charts of Hispanic patients on file with the tumor registry at Bellevue Hospital Center in New York City from 1976 to 1995 were reviewed. Demographic and pathologic data including patient age and cancer location were analyzed. Lesions of the distal colon and rectum accounted for more than 70%, while right-sided lesions were found in 20.7% of patients. The male to female ratio was 47.6% to 52.4%. The overall mean age of patients was 60.4 years. Proximal lesions presented at a later age than distal lesions, 63.2 years for the right colon and 58.5 years for the rectum; this difference in ages was significant. These results suggest that Hispanic-American patients with colorectal cancer appear to be presenting at an earlier age than the general American population. Further study is needed to determine whether Hispanic women are presenting with a higher frequency of colorectal cancer than their male counterparts and whether Hispanic patients are presenting at an earlier age than the general population with colorectal malignancies and why.

The anatomic distribution of colorectal cancer in a New York City Puerto Rican group.

Studies have attempted to define the anatomic distribution of colorectal cancer in some black and white groups of the U.S. However, little, if any research has looked at the regional distribution of colorectal cancer in an American Hispanic, especially Puerto Rican, group. This study attempts to provide some insight into the subsegmental distribution of colorectal cancer in this group of the American population which has a heavy concentration of people in many major U.S. cities. We retrospectively reviewed the charts of Puerto Rican patients who had colorectal adenocarcinoma and were on the files of the tumor registries of two principal teaching hospitals of a New York City medical school from 1976-95, and collected the age and location of the cancers. Patients were self identified as being of Puerto Rican descent. Right colon cancers were from the cecum up to the hepatic flexure, left from the splenic flexure down to the sigmoid colon, rectal which included rectosigmoid, transverse and cancers of unknown locations. The latter were not included in the anatomic analysis since the location was not known. There were eleven of these patients. The anatomic analysis was of 134 patients. There were 67 women, and 78 men with a mean age of 60.3 years, and 63.7 years respectively with an overall mean age of 62.2 years. The anatomic distribution of the cancers were as follows: right colon cancer represented 22.4% or 30/134, transverse lesions equaled 1.5% or 2/134, left cancers were found in 38.0% or 51/134, rectal malignancies equaled 38.0% or 51/134. Previously, it has been shown that the presentation of right sided colorectal cancer in white and black Americans is greater than the 22.4% seen in the Puerto Rican group of this study. However, these previous groups have been found to have 50% of cancers located distal to the splenic flexure, similar to the Puerto Ricans in this study. The average age of Puerto Ricans presenting with colorectal cancer compared to the average age of the general population may be different. Screening techniques for colorectal cancer may be adequate for detecting colorectal cancer in Puerto Ricans, however if they are indeed presenting at a relatively early age, the techniques may need to be applied earlier in comparison to the general American population. Further study is needed to see if the age of presentation is indeed as early as suggested by the present study.