Anatomic distribution of colonic cancers in middle-class black Americans

Clinical experience with 80 cases of colorectal carcinoma in middle-class black patients, focusing principally upon site and stage of the tumors and extent of survival, is presented. Data support the clinical impression that blacks have relatively more proximal colonic tumors than the general population. They also suggest that early full study of the colon, including barium enema with air contrast or colonoscopy (opposed to flexible sigmoidoscopy), is highly indicated in screening or work-up for earlier diagnosis in patients, especially blacks suspected of having polyps or carcinoma of the colon. These data do not provide evidence that these middle-class patients, with their comparative socioeconomic advantages, have significantly improved survival over previously reported series of blacks.