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Lower albumin levels in African Americans at colon cancer diagnosis: a potential explanation for outcome disparities between groups?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aim

Colorectal cancer is the third most common cancer and 3rd leading cause of cancer-related death in the USA. African Americans (AA) have inferior outcomes when matched for diagnosis stage and socioeconomic situation. Nutritional status, at diagnosis and its contribution to the observed cancer outcome disparity, between AA and non-Hispanic whites (nHw) has not been evaluated to date. The aim of the investigation was to determine if differences in nutritional surrogate markers, such as serum albumin and body mass index (BMI), exist at the time of colorectal cancer diagnosis between AA and nHw.

Methods

The University of Florida College of Medicine-Jacksonville endoscopy database was reviewed for all patients with a biopsied colorectal mass between January 2000 and December 2007. Patients were excluded if histology did not reveal colorectal adenocarcinoma or albumin/BMI was unavailable. Demographic data, tumor location, serum albumin within 60 days of diagnosis, presence of diabetes along with serum HbA1c were obtained.

Results

During the study period, 321 patients had colorectal masses discovered and 156 met entry criteria. There was no difference between ethnic groups regarding gender distribution, tumor location, diabetes presence, or BMI. Mean albumin was significantly less in AA compared to nHw (p < 0.01). This persisted after adjustment for gender, presence/absence of diabetes, and BMI.

Conclusions

Lower albumin levels in AA indicate poorer nutritional status at colorectal cancer diagnosis compared to nHw. This may contribute to the outcome disparities observed between AA and nHw. Aggressive nutritional interventions to reverse this disparity should be evaluated.

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Conflicts of interest

No conflict of interest exists for all authors.

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Authors and Affiliations

  1. Division of Gastroenterology, University of Florida College of Medicine/Jacksonville, Jacksonville, FL, 32207, USA

    Aja S. McCutchen, Juan Carlos Munoz, Lacie Brenner & Kenneth J. Vega

  2. Department of Medicine, University of Florida College of Medicine/Jacksonville, Jacksonville, FL, 32207, USA

    Peter Wludyka

  3. Division of Digestive Diseases and Nutrition, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, WP 1345, Oklahoma City, OK, 73104, USA

    Kenneth J. Vega

Authors
  1. Aja S. McCutchen
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  2. Juan Carlos Munoz
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  3. Lacie Brenner
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  4. Peter Wludyka
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  5. Kenneth J. Vega
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Corresponding author

Correspondence to Kenneth J. Vega.

Additional information

This manuscript has not been published previously, presently accepted, or under consideration for publication elsewhere.

Drs. McCutchen, Munoz, Brenner, Wludyka, and Vega each provided substantial contributions to study conception and design, acquisition of data, interpretation of data, manuscript drafting, and revising for intellectual content as well as approved this final version for submission.

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McCutchen, A.S., Munoz, J.C., Brenner, L. et al. Lower albumin levels in African Americans at colon cancer diagnosis: a potential explanation for outcome disparities between groups?. Int J Colorectal Dis 26, 469–472 (2011). https://doi.org/10.1007/s00384-011-1134-7

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  • DOI: https://doi.org/10.1007/s00384-011-1134-7

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