The anatomic distribution of colorectal cancer in a New York City Puerto Rican group

Studies have attempted to define the anatomic distribution of colorectal cancer in some black and white groups of the U.S. However, little, if any research has looked at the regional distribution of colorectal cancer in an American Hispanic, especially Puerto Rican, group. This study attempts to provide some insight into the subsegmental distribution of colorectal cancer in this group of the American population which has a heavy concentration of people in many major U.S. cities. We retrospectively reviewed the charts of Puerto Rican patients who had colorectal adenocarcinoma and were on the files of the tumor registries of two principal teaching hospitals of a New York City medical school from 1976-95, and collected the age and location of the cancers. Patients were self identified as being of Puerto Rican descent. Right colon cancers were from the cecum up to the hepatic flexure, left from the splenic flexure down to the sigmoid colon, rectal which included rectosigmoid, transverse and cancers of unknown locations. The latter were not included in the anatomic analysis since the location was not known. There were eleven of these patients. The anatomic analysis was of 134 patients. There were 67 women, and 78 men with a mean age of 60.3 years, and 63.7 years respectively with an overall mean age of 62.2 years. The anatomic distribution of the cancers were as follows: right colon cancer represented 22.4% or 30/134, transverse lesions equaled 1.5% or 2/134, left cancers were found in 38.0% or 51/134, rectal malignancies equaled 38.0% or 51/134. Previously, it has been shown that the presentation of right sided colorectal cancer in white and black Americans is greater than the 22.4% seen in the Puerto Rican group of this study. However, these previous groups have been found to have 50% of cancers located distal to the splenic flexure, similar to the Puerto Ricans in this study. The average age of Puerto Ricans presenting with colorectal cancer compared to the average age of the general population may be different. Screening techniques for colorectal cancer may be adequate for detecting colorectal cancer in Puerto Ricans, however if they are indeed presenting at a relatively early age, the techniques may need to be applied earlier in comparison to the general American population. Further study is needed to see if the age of presentation is indeed as early as suggested by the present study.