Abstract A99: Early colorectal cancer in an inner city hospital: Is the current guideline detecting preneoplastic lesions early enough?

Abstract Background: Early colorectal cancer refers to cancer diagnosed prior to the screening age of 50 years old or before the age of 55. Each patient's risk for the development of colorectal cancer is influenced by age and race. Previous studies showed evidence that there is a higher burden of colorectal adenoma and possibly colorectal cancer in young African Americans more than 45 years old which may indicate that onset of this cancer maybe younger in this population group. The Committee of Minority Affairs and Cultural Diversity of the American College of Gastroenterology (ACG) recommends screening of African Americans at the age of 45, however, current clinical practice makes no distinction as to race. The objective of the study is to determine if race has an effect on the age and location of colorectal cancer on diagnosis. This study aims to provide supporting data in customizing screening practices in the African American population. Methods: The study is a retrospective review of records of patients diagnosed with colorectal cancer before 55 years old at the Cancer Institute Tumor Registry from 2000–2008 at Albert Einstein Medical Center, Philadelphia. The populations being compared were age and risk matched. Patients with risk factors for colorectal cancer or with metastatic cancer to the colon will be excluded from the study. Descriptive statistics and frequency distribution were used to categorize the characteristics of the subjects. Chi-square test was used for bivariate analysis. Logistic regression will be used for multivariate analysis. Results: A total of 196 colorectal cancer patients were diagnosed before the age of 55 years old from 2000–2008. 116 (59.2%) were Caucasian, 54 (27.6%) were African American, 7 (3.6%) were Asian and 17 (8.7%) were from other racial groups. 106 (54.1%) were males while 90 (45.9%) were females. The mean age of diagnosis for African Americans was 48.07, SD 6.475 and Caucasians was 47.58, SD 6.740. Majority of the cancers were in the distal part of the colon (73.3% - African Americans; 61.1% - Caucasians). For both groups, majority of the cases were diagnosed at an advanced stage (41.4% stage 3 and 35% stage 4). Using chi square analysis, there is no significant difference between the age of diagnosis (p=0.188) and location (p=0.640) of colorectal cancer among African Americans and Caucasians. Conclusion: There was no disparity in the diagnosis of early colorectal cancer among African Americans and Caucasians in terms of age of diagnosis, stage and location. These patients usually present with cancer at an advanced stage and are commonly found in the distal parts of the colon. The data suggests that early cancers may be less influenced by race as previously described and that screening at age 45 for the entire population is reasonable. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A99.