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Colorectal Tumors Within an Urban Minority Population in New York City

  • Populations at Risk
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Abstract

BACKGROUND

Data on gender- and age-specific predisposition to colorectal tumors and colorectal tumor location and stage among the urban minority population in Northeastern United States is limited.

OBJECTIVE

To study the age and gender distribution of colorectal tumor type, location, and stage of colorectal tumors among urban minorities.

DESIGN

Retrospective analysis of a database of 4,043 consecutive colonoscopies performed over a 2-year period.

PARTICIPANTS/MEASUREMENTS

Of study participants, 99% were Hispanic or African American and two-thirds were women. Age, gender, colonoscopy findings, and biopsy results were analyzed in all study subjects. Outcome measures are expressed as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS

Colonoscopies, 2,394 (63.4%), were performed for cancer screening. Women had higher visit volume adjusted odds to undergo colonoscopy (OR 1.35; CI 1.26–1.44, P < .001). Individuals, 960 (23.7%), had adenomas, and 82 (2.0%) had colorectal cancer. Although cancers were outnumbered by adenomas in the colon proximal to splenic flexure (OR 0.48; CI 0.29–0.80 P = .002), 51% of all abnormalities and 35.4% of cancers were found in this region. Of cancers, 75% belonged to AJCC stage 0 to 2. Men had higher odds for both adenomas and cancers (OR 2.38, CI 2.0–2.82, P < .001). More polyps occurred at a younger age. Of the cancers, 38% were noted among the 50- to 59-year-old subjects. However, the odds of colorectal cancers were higher at age greater than 70 years (OR 1.91; CI 1.09–3.27, P < .05), specifically among men (OR 2.27, 95% CI 1.07–4.65, P < .05).

CONCLUSION

Our study of colonoscopies demonstrates lower odds of colonoscopy after adjusting for visit volume and greater predilection for colorectal cancer among urban minority men. Although older individuals were more likely to have colorectal cancer, a high percentage of colorectal tumors were noted at a younger age. These findings emphasize the vital need for preventive health education and improving early access to colorectal screening among urban minority men. A large proportion of colorectal tumors were found proximal to splenic flexure, which supports colonoscopy as the preferred method for colorectal cancer screening in the urban minority population in New York City.

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Acknowledgements

No additional individuals participated in the manuscript preparation other than the authors listed in the title section. Financial support for patient navigation was provided by the City of New York Trust Fund.

Conflict of Interests

None disclosed.

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Correspondence to Balavenkatesh Kanna MD MPH.

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Kanna, B., Schori, M., Azeez, S. et al. Colorectal Tumors Within an Urban Minority Population in New York City. J GEN INTERN MED 22, 835–840 (2007). https://doi.org/10.1007/s11606-007-0156-x

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  • DOI: https://doi.org/10.1007/s11606-007-0156-x

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