2008 Annual Meeting Abstracts
Increasing Rates of Colorectal Cancer Incidence and Mortality Among Racial Minorities in Connecticut
Stanley K. Frencher, Jr., MD ,MPH1, Walter E. Longo, MD, MBA1, Paul A. Sullivan, BA1, Charles Cha, MD1, Robert A. Kozol, MD2.
1Yale University School of Medicine, NEW HAVEN, CT, USA, 2University of Connecticut School of Medicine, HARTFORD, CT, USA.
Objective: To examine racial differences in rates and outcomes of colorectal cancer (CRC)
Design: Retrospective descriptive analysis
Setting: Data from Connecticut Tumor Registry (CTR)
Patients: 50,107 cases of CRC reported to CTR between 1983 and 2003
Main Outcome Measures: Relative incidence and mortality rates of colorectal cancer in blacks and whites
Results: The mean age at presentation was 71years; 25,250 were men (51%); and 47,267 (94%) were white. Among blacks, the mean age at presentation was 65 years and 53% (1,291) were women. We stratified the patient population with CRC by seven-year intervals demonstrating the following state-based incidences: 1983 to 1989, 74.6 cases per 100,000 population; 1990 to 1996, 68.0 cases per 100,000 population; and 1997 to 2003, 69.6 cases per 100,000 population. The proportion of blacks diagnosed with CRC increased from 3.8% to 5.8%. CRC incidences per 100,000 black population rose by 17%. Blacks diagnosed with CRC were 10% more likely to die than whites.
Conclusions: Blacks were the only cohort which had persistently increasing rates of CRC from 1983 to 2003 while the overall incidence of CRC in Connecticut fluctuated. The disproportionately higher numbers of blacks, particularly black women, diagnosed with CRC reversed the previously decreasing trend in CRC incidence. Blacks present with CRC at younger ages and had higher mortality rates. Achieving racial equity in prevention, diagnosis and treatment of CRC could lead to improved clinical outcomes. Further investigation is needed to reveal the causes of these disparities.