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The distribution and pathological staging of colorectal cancers in ethnic groups
Alok Tiwari1, Tun Kwan Yeo, Solon Riris
1Department of Surgery, North Middlesex University Hospital, Edmonton, London, UK.
Background:
There is little data on the distribution and histological staging of colorectal cancer in ethnic groups in the United Kingdom. A study to investigate this was undertaken at a hospital serving a multi-ethnic population.
Patients And Methods:
Case analysis from a prospective database of all colorectal cancers between 2000-2004 was performed. Data was recorded on the distribution of cancer, operative procedures and Dukes' staging.
Results:
A total of 256 patients (118 females) were diagnosed with colorectal cancer, of whom 214 (83.6%) underwent resection. There were 39 Afro-Caribbeans 66.2 years +/- 12.6 years; mean [age +/- s.d.], 14 Asians 64 years +/- 12.6 years, 34 Mediterraneans 67.7 years +/- 9.9 years and 176 Caucasian British 74.3 years +/- 11.3 years. Right-sided colonic lesions were more frequent in Afro-Caribbeans, whilst left-sided lesions were more frequent in Mediterraneans. The incidence of Dukes'A cancer was high in Mediterraneans whilst Dukes' C cancer was commoner in Caucasians and Afro-Caribbeans.
Conclusion:
Ethnic patients present with colorectal cancer at significantly younger ages. Afro-Caribbeans have significantly more right-sided and Mediterraneans more left-sided cancer. Afro-Caribbean and Caucasian patients present with more advanced cancer compared to Mediterraneans. This has implications on the investigation, as well as screening in ethnic minority patients.
