Prevalence of Advanced, Precancerous Colorectal Neoplasms in Black and White Populations: A Systematic Review and Meta-analysis

Imperiale, Thomas F.; Abhyankar, Priya; Stump, Timothy E.; Emmett, Thomas W.

doi:10.1053/j.gastro.2018.08.020

Cited by 23 publications

(16 citation statements)

References 32 publications

(65 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…No conclusive evidence exists for any sort of racial/ethnic biological or genetic determinant of CRC outcomes. [39][40][41][42] On the other hand, cultural and personal beliefs, though difficult to measure, may substantially impact health outcomes. Indeed, studies have shown that even when rates of specialist consultations are similar between Black and…”

Section: Disparities In Treatment Receipt and Relative Cost Ratiosmentioning

confidence: 99%

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

Tramontano¹,

Chen²,

Watson³

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

Background Our study analyzed disparities in utilization and phase-specific costs of care among older colorectal cancer patients in the United States. We also estimated the phase-specific costs by cancer type, stage at diagnosis, and treatment modality. Methods We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database to identify patients aged 66 or older diagnosed with colon or rectal cancer between 2000-2013, with follow-up to death or December 31, 2014. We divided the patient's experience into separate phases of care: staging or surgery, initial, continuing, and terminal. We calculated total, cancer-attributable, and patient-liability costs. We fit logistic regression models to determine predictors of treatment receipt and fit linear regression models to determine relative costs. All costs are reported in 2019 US dollars. Results Our cohort included 90,023 colon cancer patients and 25,581 rectal cancer patients. After controlling for patient and clinical characteristics, Non-Hispanic Blacks were less likely to receive treatment but were more likely to have higher cancer-attributable costs within different phases of care. Overall, in both the colon and rectal cancer cohorts, mean monthly cost estimates were highest in the terminal phase, next highest in the staging phase, decreased in the initial phase, and were lowest in the continuing phase. Conclusions Racial/ethnic disparities in treatment utilization and costs persist among colorectal cancer patients. Additionally, colorectal cancer costs are substantial and vary widely among stages and treatment modalities. This study provides information regarding cost and treatment

show abstract

Section: Disparities In Treatment Receipt and Relative Cost Ratiosmentioning

confidence: 99%

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

Tramontano¹,

Chen²,

Watson³

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…CRC has many causes, and it is generally believed that genetics, age, environment, lifestyle, and other factors affect its occurrence CRC [6–8]. Among these other factors, dietary patterns have received the most recent attention [9–12].…”

Section: Introductionmentioning

confidence: 99%

A Reasonable Diet Promotes Balance of Intestinal Microbiota: Prevention of Precolorectal Cancer

Huang

Liu

2019

BioMed Research International

View full text Add to dashboard Cite

Colorectal cancer (CRC) is a multifactorial disease and the second leading cause of cancer death worldwide. The pathogenesis of colorectal cancer includes genetics, age, chronic inflammation, and lifestyle. Increasing attention has recently been paid to dietary factors. Evidence from epidemiological studies and clinical research suggests that high-fibre diets can significantly reduce the incidence of CRC, whilst the consumption of high-fat diets, high-protein diets, red meat, and processed meat is high-risk factors for tumorigenesis. Fibre is a regulator of intestinal microflora and metabolism and is thus a key dietary component for maintaining intestinal health. Intestinal microbes are closely linked to CRC, with the growth of certain microbiota (such as Fusobacterium nucleatum, Escherichia coli, or Bacteroides fragilis) favouring carcinogenesis, whilst the dominant microbiota population of the intestine, such as Bacteroidetes, Firmicutes, Actinobacteria, and Proteobacteria, have multiple mechanisms of antitumour activity. Various dietary components have direct effects on the types of intestinal microflora: in the Western diet mode (high-fat, high-protein, and red meat), the proportion of conditional pathogens in the intestinal flora increases, the proportion of commensal bacteria decreases, and the occurrence of colorectal cancer is promoted. Conversely, a high-fibre diet can increase the abundance of Firmicutes and reduce the abundance of Bacteroides and consequently increase the concentration of short-chain fatty acids (SCFAs) in the intestine, inhibiting the development of CRC. This article reviews the study of the relationship between diet, intestinal microbes, and the promotion or inhibition of CRC and analyses the relevant molecular mechanisms to provide ideas for the prevention and treatment of CRC.

show abstract

“…38 A prior study demonstrated no difference in advanced precancerous colorectal neoplasms (largely comprised of advanced polyps, precursor lesions for most CRCs) between Blacks and Whites undergoing average-risk colonoscopy. 39 The authors concluded differences in CRC incidence are less likely due to biology and more likely due to behavioral or sociocultural differences in symptom recognition, need for diagnostic evaluation and/or access or uptake of preventive services and the age to initiate screening need not vary based on race alone. Given marked geographic and intra-racial EOCRC rate disparities we have identified within both White and Black populations at very young ages (i.e., [30][31][32][33][34][35][36][37][38][39], prior to screening age) argues other factors in addition to symptom recognition or screening access may underlie such variations.…”

Section: Discussionmentioning

confidence: 99%

Geographic and intra‐racial disparities in early‐onset colorectal cancer in the SEER 18 registries of the United States

et al. 2020

View full text Add to dashboard Cite

Background Although early‐onset colorectal cancer (EOCRC) incidence rates (IRs) are increasing, geographic and intra‐racial IR disparities are not well defined. Methods 2000‐2015 Surveillance, Epidemiology, and End Results (SEER) program CRC IR Analysis (170,434 cases) was performed from ages 30 to 60 in four US regions, 18 individual registries, metropolitan and nonmetropolitan locations and stratified by race. Analyses were conducted in 1‐year and 5‐year age increments. Results Wide US regional EOCRC IR variations exist: For example, age 45 IRs in the south are 26.8/100,000, 36.0% higher than the West, 19.7/100,000 ( p < 0.0001). Disparities magnify between individual registries: EOCRC IRs in highest risk registries were 177‐348% (Alaska Natives), 75‐200% (Hawaii), 76‐128% (Louisiana), and 61‐125% (Kentucky) higher than lowest risk registries depending on age. EOCRC IRs are 18.2%‐25.6% higher in nonmetropolitan versus metropolitan settings. Wide geographic intra‐racial disparities exist. Within the White population, the greatest IR difference (78.8%) was between Kentucky (5.9/100,000) and Los Angeles (3.3/100,000) in 30‐ to 34‐year‐olds ( p < .0001). Within the Black population, the greatest difference (136.2%) was between rural Georgia (30.7/100,000) and California excluding San Francisco‐Oakland/San Jose‐Monterey/Los Angeles (13/100,000) in 40‐ to 44‐year‐olds ( p = 0003). Conclusion Marked geographic EOCRC disparities exist with disproportionately high IRs in Alaska Natives, Hawaii, and southern registries. Geographic intra‐racial disparities are present within White and Black populations. In Blacks, there are disproportionately high EOCRC IRs in rural Georgia. Although vigilance is required in all populations, attention must be paid to these higher risk populations. Potential interventions include assuring early investigation of symptoms, targeting modifiable risk factors and utilizing earlier age 45 screening options supported by some guidelines.

show abstract

Prevalence of Advanced, Precancerous Colorectal Neoplasms in Black and White Populations: A Systematic Review and Meta-analysis

Abstract: In this meta-analysis, we found the overall prevalence of AA and ACN did not differ significantly between average-risk black and white persons, indicating that the age at which to begin colorectal cancer screening need not differ based on race alone.

Cited by 23 publications

References 32 publications

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

Racial/ethnic disparities in colorectal cancer treatment utilization and phase-specific costs, 2000-2014

A Reasonable Diet Promotes Balance of Intestinal Microbiota: Prevention of Precolorectal Cancer

Geographic and intra‐racial disparities in early‐onset colorectal cancer in the SEER 18 registries of the United States

Contact Info

Product

Resources

About