Factors contributing to the black/white colorectal cancer survival disparity in nonelderly patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3587-3587
Author(s):  
Helmneh M. Sineshaw ◽  
Kimmie Ng ◽  
W. Dana Flanders ◽  
Otis W. Brawley ◽  
Ahmedin Jemal
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Cancer Survival ◽  
Tumor Location ◽  
National Cancer Data Base ◽  
Future Research ◽  
Treatment Matching ◽  
Entire Cohort ◽  
Cancer Data ◽  
Survival Difference

3587 Background: Previous studies reported that black/white survival disparities among elderly colorectal cancer (CRC) patients largely reflect differences in tumor presentation rather than differences in treatment. We sought to determine the contribution of differences in tumor presentation and receipt of treatment to the black/white survival disparity among nonelderly CRC patients. Methods: We selected non-Hispanic black (black) and Non-Hispanic white (white) patients aged 18-64 years, and diagnosed between 2004-2012 with single or first primary invasive stage I-IV CRC in the National Cancer Data Base. Blacks were sequentially matched with three white comparison cohorts, using propensity score and greedy matching algorithm, by demographics (age, sex, diagnosis year, region), tumor presentation (stage, grade, margin, tumor location, node status, comorbidity score), and treatment (surgery, chemotherapy, radiotherapy, metastatectomy) characteristics. We used Kaplan-Meier method to estimate 5-year survival for blacks compared with whites in the entire cohort and in the three sequentially matched cohorts. Results: In the entire cohort, 5-year survival was 9.2% lower in nonelderly blacks than whites (57.3% vs 66.5%). The survival difference remained unchanged after demographic matching, but it decreased to 3.3% (5.9% absolute and 64% relative reductions) after tumor presentation matching, and to 2.6% (0.7% absolute and 7.6% relative reductions) after treatment matching. By anatomic subsite, treatment matching reduced the black/white 5-year survival difference by 26% (3%/11.5%) for rectal cancer, only by 5.6% (0.5%/9%) for left colon cancer, and no change for right colon cancer. Conclusions: Differences in tumor presentation characteristics explained about two-thirds of the black/white survival disparity in nonelderly CRC patients, while treatment explained less than ten percent of the disparity. Future research should explore the biological mechanisms underlying these observed differences in tumor presentation and implications for treatment.

Disparities in the Age-Related Rates of Colorectal Cancer in the United States

2017 ◽  
Vol 83 (6) ◽  
pp. 640-647 ◽  
Author(s):  
Emmanuel Gabriel ◽  
Katherine Ostapoff ◽  
Kristopher Attwood ◽  
Eisar Al-Sukhni ◽  
Patrick Boland ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Age Groups ◽  
The United States ◽  
National Cancer Data Base ◽  
Stage Iii ◽  
Cancer Data ◽  
Age Related ◽  
Rate Of Increase ◽  
Hispanic Patients

The incidence of colorectal cancer (CRC) among Americans under the age of 50 years is increasing. The purpose of this study was to identify racial and socioeconomic disparities associated with this trend. The National Cancer Data Base was used to identify patients with CRC from 1998 to 2011. Patients were stratified by age (<50 versus >60 years), with ages 50 to 60 years omitted from the analysis to minimize overlapping trends between the two age groups. Relative frequencies (RFs) by year were plotted against demographic variables. Changes in RF over time and intervals from diagnosis to treatment (including surgery and chemotherapy) were compared. A total of 1,213,192 patients were studied; 885,510 patients with colon cancer and 327,682 with rectal or rectosigmoid cancer. Patients <50 years had higher RF for stage III/IV CRC compared with >60 years, with the highest rate of increase in stage III colon cancer (0.198% per year). Patients <50 years had higher RF for CRC if they were African-American or Hispanic. Hispanic patients <50 years had the highest rates of increase for both colon (RF = 0.300% per year) and rectal cancer (RF = 0.248% per year). Compared with race, other variables including education and income were not found to have as strong an association on age-related rates of CRC. No clinically significant differences were observed for time from diagnosis to treatment in either age group. Important racial disparities are associated with differences in age-related CRC rates, warranting further investigation to develop improved strategies for the earlier detection of CRC in these populations.

Effect of colon cancer sidedness compared to tumor biology on stage-specific survival.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 543-543 ◽  
Author(s):  
Ahmed Dehal ◽  
Brooke Vuong ◽  
Amanda N Graff-Baker ◽  
Jihey Lee ◽  
Anton Bilchik ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Tumor Biology ◽  
National Cancer Data Base ◽  
Hepatic Flexure ◽  
Stage I ◽  
Stage Ii ◽  
National Database ◽  
Cancer Data ◽  
Right Colon Cancer ◽  
Survival Difference

543 Background: Recent studies have reported a survival difference between right colon cancer (RCC) and left colon cancer (LCC) but were limited by lack of data on surgical therapy and underlying tumor biology including microsatellite instability (MSI) status. Our objective was to examine the influence of tumor sidedness on stage-specific survival after adjustment for those factors using a large national database. Methods: Adult patients with primary invasive colon cancer were identified from the National Cancer Data Base (NCDB) between 2009 and 2012. Cecum, ascending colon, hepatic flexure, and transverse colon were classified as “RCC” and sigmoid, descending colon, and splenic flexure were classified as “LCC”. Differences in 3-year overall survival (OS) between RCC versus LCC, stratified by stage, were obtained. Results: Of 24,092 patients, 9,095 (37.75%) presented with a LCC and 14,997 (62.25%) with a RCC. After adjustment for confounding factors, including demographics, MSI, KRAS, nodal retrieval and treatment, patients with RCC stage I, III, or IV had a 31-35% decreased OS compared to those with a LCC. However, in patients with stage II disease, RCC had a 15% improvement in OS compared to LCC (Table 1). MSI positivity was not significantly different in RCC versus LCC stage for stage nor did it contribute to decreased OS for either side. Conclusions: Colon cancer sidedness is an independent risk factor for decreased survival after adjusting for potential confounders including tumor biology and treatment characteristics. For patients with stage I, II, and IV disease, RCC portends a decreased survival compared to LCC, whereas the opposite is true for patients with stage II disease. Further research is needed to elucidate the exact the role of sidedness in risk-profiling and staging for colon cancer patients. [Table: see text]

The National Cancer Data Base report on colon cancer

Cancer ◽  
1996 ◽  
Vol 78 (4) ◽  
pp. 918-926 ◽  
Author(s):  
J. Milburn Jessup ◽  
Lamar S. McGinnis ◽  
Glenn D. Steele ◽  
Herman R. Menck ◽  
David P. Winchester
Keyword(s):  
Colon Cancer ◽  
Data Base ◽  
National Cancer Data Base ◽  
Cancer Data

scholarly journals High expression of Wnt7a protein predicts a poor survival in patients with colorectal carcinoma

2020 ◽  
Author(s):  
Congcong Li ◽  
Peilin Cui ◽  
Xiaowei Dou ◽  
Hongli Li ◽  
Jiahuan Sun ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Malignant Tumors ◽  
Integration Site ◽  
Normal Mucosa ◽  
Lymph Node Involvement ◽  
Colorectal Adenomas ◽  
Future Research ◽  
Colorectal Mucosa ◽  
Staining Score

Abstract Background: Colorectal cancer is one of the most common malignant tumors in China, and the number of new cases and the number of cases of deaths has increased annually. However, its pathogenesis is still unclear. Wnt7a is a member of the wingless-type MMTV integration site family, and it plays an important role in tumorigenesis and development by controlling cell proliferation and differentiation as a secreted glycoprotein. Whether Wnt7a has the properties of an oncogene or not is an important focus for future research as this target has diverse roles in different tumors.Methods: Wnt7a protein expression in normal colorectal mucosa and colorectal tumors was detected via immunohistochemistry and Western blot analysis. Univariate and multivariate analyses were used to explore the associations between Wnt7a staining score and various clinical parameters.Results: Wnt7a was strongly expressed in colorectal cancer tissues but weakly expressed in adjacent normal mucosa and colorectal adenomas. The level of Wnt7a expression was correlated with lymph node involvement (P < 0.001), Duke stage (P < 0.001), and cell differentiation (P < 0.001). Knockdown of Wnt7a inhibits proliferation of colon cancer cells and inhibits the ability of both colon cancer cell lines to migrate.Conclusions: Collectively, our results present evidence that Wnt7a is associated with an unfavorable prognosis of colorectal cancer.

Variation in Hospital-Specific Rates of Suboptimal Lymphadenectomy and Survival in Colon Cancer: Evidence from the National Cancer Data Base

2016 ◽  
Vol 23 (S5) ◽  
pp. 674-683 ◽  
Author(s):  
Adan Z. Becerra ◽  
Mariana E. Berho ◽  
Christian P. Probst ◽  
Christopher T. Aquina ◽  
Mohamedtaki A. Tejani ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Data Base ◽  
National Cancer Data Base ◽  
Cancer Data

scholarly journals Cross-platform Data Analysis Reveals a Generic Gene Expression Signature for Microsatellite Instability in Colorectal Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Anna Pačínková ◽  
Vlad Popovici
Keyword(s):  
Gene Expression ◽  
Colorectal Cancer ◽  
Colon Cancer ◽  
Microsatellite Instability ◽  
Gene Expression Signature ◽  
Data Sets ◽  
Rna Seq ◽  
Cancer Data ◽  
Expression Signature ◽  
Endometrial Cancers

The dysfunction of the DNA mismatch repair system results in microsatellite instability (MSI). MSI plays a central role in the development of multiple human cancers. In colon cancer, despite being associated with resistance to 5-fluorouracil treatment, MSI is a favourable prognostic marker. In gastric and endometrial cancers, its prognostic value is not so well established. Nevertheless, recognising the MSI tumours may be important for predicting the therapeutic effect of immune checkpoint inhibitors. Several gene expression signatures were trained on microarray data sets to understand the regulatory mechanisms underlying microsatellite instability in colorectal cancer. A wealth of expression data already exists in the form of microarray data sets. However, the RNA-seq has become a routine for transcriptome analysis. A new MSI gene expression signature presented here is the first to be valid across two different platforms, microarrays and RNA-seq. In the case of colon cancer, its estimated performance was (i) AUC = 0.94, 95% CI = (0.90 – 0.97) on RNA-seq and (ii) AUC = 0.95, 95% CI = (0.92 – 0.97) on microarray. The 25-gene expression signature was also validated in two independent microarray colon cancer data sets. Despite being derived from colorectal cancer, the signature maintained good performance on RNA-seq and microarray gastric cancer data sets (AUC = 0.90, 95% CI = (0.85 – 0.94) and AUC = 0.83, 95% CI = (0.69 – 0.97), respectively). Furthermore, this classifier retained high concordance even when classifying RNA-seq endometrial cancers (AUC = 0.71, 95% CI = (0.62 – 0.81). These results indicate that the new signature was able to remove the platform-specific differences while preserving the underlying biological differences between MSI/MSS phenotypes in colon cancer samples.

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