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Colorectal carcinoma in poor blacks.

Harold P Freeman1, Tarek A Alshafie

  • 1Department of Surgery, Harlem Hospital Center, College of Physician and Surgeons of Columbia University, New York, New York, USA. harold.freeman@ngsc.org

Cancer
|May 17, 2002
PubMed
Summary

Colorectal cancer survival rates remain alarmingly low for African Americans in inner cities due to late diagnosis. Addressing barriers like poverty and lack of healthcare access is crucial for improving outcomes.

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Area of Science:

  • Oncology
  • Public Health
  • Health Disparities

Background:

  • Colorectal carcinoma (CRC) disproportionately affects African Americans, particularly urban populations.
  • Harlem Hospital serves a socioeconomically disadvantaged, predominantly Black community in New York City.

Purpose of the Study:

  • To analyze CRC patient demographics, treatment, and survival rates at Harlem Hospital.
  • To identify factors contributing to high CRC mortality in an underserved urban population.

Main Methods:

  • Retrospective review of 615 colorectal carcinoma patient records from Harlem Hospital (1973-1992).
  • Analysis of patient demographics, clinical stage at diagnosis, treatment modalities, and survival outcomes.
  • Comparison of survival rates to national averages.

Main Results:

  • The study population was 97.2% Black, with 82% residing in Harlem.
  • All patients presented with symptoms; 39.0% were diagnosed at Stage IV.
  • The 5-year crude survival rate was 18.7%, significantly lower than the national average.

Conclusions:

  • CRC mortality remains high in this urban Black population, contrasting national trends.
  • Late presentation at incurable stages, driven by poverty, lack of education, and limited healthcare access, is the primary cause.
  • Culturally sensitive education and accessible healthcare systems are essential for this population.

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