There are many factors that influence your risk for a certain disease. Some factors, such as your body weight, level of physical activity and whether you smoke, can be managed. Other factors, like race and ethnicity, are outside of your control but play a key role when it comes to diseases like colon cancer. African Americans are at higher risk for colon cancer, which means that African Americans should have a baseline colonoscopy at the age of 45 instead of 50.
With the increased incidence of young-onset colon cancer, doctors and researchers are eager to find out more about the racial disparity in colon cancer incidence and survival. Elena M. Stoffel, M.D., M.P.H., assistant professor of internal medicine at University of Michigan Health System, examined survival among patients diagnosed with young-onset colon cancer. Stoffel noticed two trends:
- Colon cancer is rising among patients previously considered too young to be screened
- Twice as many non-Hispanic blacks are being diagnosed with colon cancer at young ages
Stoffel and her research team used the SEER database to study 28,145 patients diagnosed with colon cancer between the ages of 20 and 49 years, from 2000 to 2009. Of the sample group, 19,497 patients were non-Hispanic whites, 4,384 were non-Hispanic blacks and 4,264 were Hispanics. About one-quarter of the patients in the cohort study received their diagnosis before the age of 40. Hispanic individuals were more likely to be diagnosed at a younger age, followed by non-Hispanic black individuals and non-Hispanic white individuals, respectively.
In almost all other categories, non-Hispanic black individuals fared worse than their counterparts. Non-Hispanic blacks were more likely to present at an advanced disease stage (stage III or stage IV) and to have higher-grade tumors than the other two groups. They also presented with cancer in the proximal colon, which is associated with greater mortality. Finally, the overall survival rate for non-Hispanic black individuals was 55 percent, compared with 68 percent for non-Hispanic white individuals and 63 percent for Hispanic individuals (Source: Healio).
“Our findings prompt the question of whether colorectal cancers that develop in young patients may actually be more aggressive and more likely to benefit from adjuvant treatments that have demonstrated only marginal benefit in older patients,” Stoffel said. “It is clear that further study is needed to identify if and how colorectal cancer tumors that develop in young individuals differ from tumors in older patients. This will enable clinicians to personalize care by selecting the treatments that will be most effective.”