Attributes and disease characteristics of patients seeking online second opinion for cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13620-e13620
Author(s):  
Rakesh Shankar Goud ◽  
Amit Kumar Jotwani ◽  
Thirtha Poovaiah ◽  
Rejil Rajan ◽  
Rama Waghmare ◽  
...  
Keyword(s):  
Hematological Malignancies ◽  
Early Stage ◽  
Locally Advanced ◽  
Tumor Board ◽  
Cancer Type ◽  
Advanced Stage ◽  
Age Group ◽  
Stage Of Disease ◽  
Disease Characteristics ◽  
True Value

e13620 Background: As we see rising cancer incidence in India, there is a parallelly increasing trend in patient-driven second medical opinions (SMO) in oncology. We analysed different attributes of patients seeking online second opinions through onco.com to help us understand the driving factors for patients. Here we present the patient and disease attributes to understand the reasons and perceived value of SMOs in oncology through an online platform. Methods: We did a retrospective analysis of 1,142 patients who availed online tumor board opinion through Onco.com between August 2018 & December 2020. Patient characteristics like age, gender, city of residence (metro or non-metro) & disease characteristics like cancer type and stage were recorded. Tumors included both solid and hematological malignancies. Results: Of the 1,142 patients, 87% (991) cases were solid tumors and the rest 13% (151) were hematological malignancies. Top 6 cancer types for which patients sought SMOs- Breast- 13%, Head & neck- 8.7%, Lung- 7.5%, Leukaemia- 5.8%, Lymphoma- 5.4%, & Ovarian- 5% cancers. Of the 991 solid tumour cases, 13% had early (stage I & II) disease, 24% had locally advanced (stage III) disease, 52% had metastatic disease & and 11% had recurrent disease. The mean age of patients was 50 years with equivalent gender distribution. 23% of patients seeking SMOs were young adults (17-44 years), 59% were older adults (45-70 years), and 9% patients were from elderly (>70 years) age group. City of residence- 39% patients were residents of metro (tier 1) cities and 61% were residents of non-metro (tier 2/3) cities. Conclusions: Advanced stage of disease (metastatic + recurrent) and non-metro city of residence were found to be the commonest attributes for majority of patients. Desperate nature of the situation in advanced stage of disease and lack of access to specialised oncology care in non-metro cities respectively appear to be the reasons for higher SMOs in these groups. Higher number of SMOs for younger age patients was disproportionate to the incidence of cancer in this age-group. A larger analysis of the contrarian opinions, compliance and clinical impact of second opinions in terms of better survival outcomes is warranted to see if patients get true value out of this exercise.

scholarly journals Surgical candidacy and treatment uptake among women with cervical cancer at public referral hospitals in Kampala, Uganda

2020 ◽  
Author(s):  
Megan L Swanson ◽  
Miriam Nakalembe ◽  
Lee-may Chen ◽  
Stefanie M Ueda ◽  
Jane Namugga ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Phone Call ◽  
Treatment Recommendation ◽  
Advanced Stage ◽  
Multivariate Statistical ◽  
Recommended Treatment ◽  
Treatment Uptake ◽  
Referral Hospitals

AbstractPurposeCervical cancer is the most common malignancy among women in Uganda. Most present with advanced disease, when hysterectomy is not possible and cure is less likely. This study reports the proportion recommended for hysterectomy and associated factors, recommended treatments by stage, and treatment uptake.MethodsWe conducted a prospective study among patients seeking care for cervical cancer at public referral hospitals in Uganda. In-person surveys were followed by a phone call. Descriptive and multivariate statistical analyses examined associations between predictors and outcomes.ResultsAmong 268 participants, 76% were diagnosed at an advanced stage (IIB-IVB). In total, 12% were recommended for hysterectomy. In adjusted analysis, living within 15 kilometers of Kampala (OR 3.10, 95% CI 1.20-8.03) and prior screening (OR 2.89, 95% CI 1.22-6.83) were significantly associated with surgical candidacy. Radiotherapy availability was not significantly associated with treatment recommendations for early-stage (IA-IIA) disease, but was associated with recommended treatment modality (chemo-radiation versus primary chemotherapy) for locally advanced stage (IIB-IIIB). Most (67%) had started treatment. No demographic or health factor, treatment recommendation, or radiation availability was associated with treatment initiation. Among those recommended for hysterectomy, 55% underwent surgery. Among those who had initiated treatment, 82% started the modality that was actually recommended.ConclusionWomen presented to public referral centers in Kampala with mostly advanced-stage cervical cancer and few were recommended for surgery. Lack of access to radiation did not significantly increase the proportion of early-stage cancers recommended for hysterectomy.

Updates in the management and future landscape of urothelial carcinoma

2020 ◽  
pp. 107815522097102
Author(s):  
Kirollos S Hanna ◽  
Maren Campbell ◽  
Adam Kolling ◽  
Alex Husak ◽  
Sabrina Sturm ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Urothelial Carcinoma ◽  
Metastatic Disease ◽  
Checkpoint Inhibitors ◽  
Early Stage ◽  
Locally Advanced ◽  
The United States ◽  
Cancer Type ◽  
Antibody Drug Conjugate ◽  
Early Stage Disease

Urothelial carcinoma is the sixth most common cancer type in the United States. Although most patients present with early stage disease which is associated with improved outcomes, many will progress to locally advanced or metastatic disease. Immune checkpoint inhibitors have significantly impacted the treatment paradigm for patients and have resulted in improved survival rates. Despite their proven efficacy, many ongoing clinical trials continue to refine combinations with chemotherapy, sequencing of therapies and the role of ligand expression. Additionally, novel targets have been identified for advanced urothelial carcinoma and have led to the approval of the antibody-drug conjugate, enfortumab vedotin, and the fibroblast growth factor receptor-targeted, erdafitinib. Enrollment in a clinical trial is strongly encouraged for all stages of advanced or metastatic disease. Numerous ongoing clinical trials are likely to impact the treatment armamentarium for patients. In this manuscript, we highlight key updates in the clinical management for patients and outline ongoing trials.

scholarly journals Histopathological, Radiological and Demographic Factors Predicting the Response to Neoadjuvant Therapy for Rectal Cancer

2021 ◽  
Author(s):  
Emine YILDIRIM ◽  
Sibel Bektas ◽  
Zekeriya Pelen ◽  
Irem Yanik ◽  
Ahmet Muzaffer Er ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymphovascular Invasion ◽  
Perineural Invasion ◽  
Early Stage ◽  
Anal Verge ◽  
Demographic Data ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Neoadjuvant Chemoradiotherapy ◽  
Advanced Stage

Abstract Background/aimWhile the treatment for early stage rectal cancer is surgery, when a diagnosis is made at a locally advanced stage, it is recommended to start treatment with neoadjuvant chemoradiotherapy. Therefore, it is important to determine which patients will respond best to neoadjuvant treatment. The aim of this study was to investigate which hematological, histopathological, and radiological parameters can predict the response to chemoradiotherapy. Methods and materialsA retrospective examination was made of 43 patients who underwent surgery following neoadjuvant chemoradiotherapy because of locally advanced stage rectal cancer. Demographic data were collected from the patient files, and the radiological, histopathological and laboratory findings before neoadjuvant chemoradiotherapy were compared with the findings after treatment. ResultsIn the postoperative evaluation, a pathological complete response was determined in 25.50% of the patients. Lymphovascular invasion, perineural invasion and absence of necrosisis were seen to be statistically related to major response (p<0.05), and in patients where the tumor was closer than 6cm to the anal verge, the response was betterConclusionWhen the findings were examined, histopathological lymphovascular invasion, perineural invasion, the presence of necrosis, and the anal verge distance were evaluated as parameters predicting the response to neoadjuvant chemoradiotherapy in rectal cancer.

scholarly journals Profil Karsinoma Kolorektal di Laboratorium Patologi Anatomi Fakultas Kedokteran Universitas Andalas Priode Januari 2009 sampai Desember 2011

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Muflikal Hamdi ◽  
Asril Zahari ◽  
Aswiyanti Asri
Keyword(s):  
Colorectal Carcinoma ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Early Stage ◽  
Advanced Stage ◽  
Age Group ◽  
Pathology Laboratory ◽  
Anatomic Pathology ◽  
Common Location ◽  
Descriptive Method

AbstrakPada stadium awal carcinoma colorectal tidak menunjukan gejala klinis yang khas, sehingga sebagian besar penderita datang pada stadium lanjut. Tujuan penelitian ini adalah untuk melihat profil carcinoma colorectal di laboratorium Patologi Anatomi Fakultas Kedokteran Universitas Andalas. Penelitian ini dilakukan pada periode Januari 2009 sampai Desember 2011 dengan metode deskriptif retrospektif . Data penelitian diambil dari rekam medis penderita carcinoma colorectal dalam penelitian yang telah dilakukan pada bulan Juni 2012 sampai bulan Oktober 2012. Pada penelitian ini di temukan 260 kasus carcinoma colorectal dengan histopatologi terbanyak yaitu adenokarsinoma 217 kasus (83,47%) dan grading/diferensiasi II sebanyak 93 kasus (42,85%). Insiden carcinoma colorectal ditemukan pada perempuan lebih tinggi daripada laki-laki dengan perbandingan 1,18 : 1. Kelompok umur terbanyak adalah 51-60 tahun (28,08%) dengan usia termuda 16 tahun dan tertua 86 tahun. Lokasi carcinoma colorectal tersering ditemukan di rektum 131 kasus (50,39%) disusul rektosigmoid 37 kasus (14,23%) dan sigmoid 27 kasus (10,39%) dengan gejala klinis terbanyak BAB berdarah dan berlendir. Pada saat skrining dengan melakukan rektal toucher masa carcinoma colorectal akan dapat teraba, sehingga kasus ini dapat ditemukan pada stadium dini dan angka morbiditas dan mortalitas akibat penyakit ini dapat diturunkan.Kata kunci: profil, carcinoma colorectal, patologi anatomi AbstractIn the early stages of colorectal carcinoma does not show typical clinical symptoms, so most people come at an advanced stage. The objective of this study was to determine the profile of colorectal carcinoma in the anatomic pathology laboratory Andalas University Faculty of Medicine.The research was conducted during the period January 2009 until December 2011 with retrospective descriptive method and the data were taken from the medical records of patients with colorectal carcinoma in the research that has been conducted in June 2012 until October of 2012. Found in this study in 260 cases of colorectal carcinoma with the highest histopathology adenocarcinoma 217 cases (83.47%) and grading/differentiation II as many as 93 cases (42.85%). Colorectal carcinoma incidence found in women is higher than men with a ratio of 1.18: 1. Largest age group was 51-60 years (28.08%) with the youngest aged 16 and the oldest 86 years. Most common location of colorectal carcinoma was found in the rectum 131 cases (50.39%) followed rektosigmoid 37 cases (14.23%) and sigmoid 27 cases (10.39%) with clinical symptoms defecate most bloody and slimy. The screening by rectal toucher will be seen colorectal carcinoma clearly, so this case can be found at an early stage and morbidity and mortality from this disease can be reduced.Keywords: profile,colorectal carcinoma, anatomic pathology

Increased Cyclooxygenase-2 Expression Is Associated With Chemotherapy Resistance and Poor Survival in Cervical Cancer Patients

2002 ◽  
Vol 20 (4) ◽  
pp. 973-981 ◽  
Author(s):  
G. Ferrandina ◽  
L. Lauriola ◽  
M. G. Distefano ◽  
G. F. Zannoni ◽  
M. Gessi ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Early Stage ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Rabbit Antiserum ◽  
Immunohistochemical Analysis ◽  
Response To Treatment ◽  
Advanced Stage ◽  
Cox 2

PURPOSE: To investigate the expression of cyclooxygenase (COX-2) and its association with clinicopathologic parameters and clinical outcome in patients with cervical cancer. PATIENTS AND METHODS: The study included 84 patients with stage IB to IVA cervical cancer. Patients with early-stage cases (n = 21) underwent radical surgery, whereas patients with locally advanced cervical cancer (LACC) (n = 63) were first administered neoadjuvant cisplatin-based treatment and subjected to surgery in case of response. Immunohistochemical analysis was performed on paraffin-embedded sections with rabbit antiserum against COX-2. RESULTS: COX-2–integrated density values in the overall population ranged from 1.2 to 82.3, with mean ± SE values of 27.4 ± 2.4. According to the chosen cutoff value, 36 (42.9%) of 84 patients were scored as COX-2 positive. COX-2 levels were shown to be highly associated with tumor susceptibility to neoadjuvant treatment. COX-2 showed a progressive increase from mean ± SE values of 19.9 ± 8.0 in complete responders through 31.5 ± 3.5 in partial responses to 44.8 ± 3.9 in patients who were not responsive (P = .0054). When logistic regression was applied, only advanced stage and COX-2 positivity retained independent roles in predicting a poor chance of response to treatment. COX-2–positive patients had a shorter overall survival (OS) rate than COX-2–negative patients. In patients with LACC, the 2-year OS rate was 38% in COX-2–positive versus 85% in COX-2–negative patients (P = .0001). In the multivariate analysis, only advanced stage and COX-2 positivity retained independent negative prognostic roles for OS. CONCLUSION: The assessment of COX-2 status could provide additional information to identify patients with cervical cancer with a poor chance of response to neoadjuvant treatment and unfavorable prognosis.

scholarly journals Time, Distance and Economics Influencing Cancer Care: Experience From a Regional Cancer Center in India

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 76s-76s
Author(s):  
N. Ballari ◽  
R. Miriyala ◽  
T. Jindia ◽  
S. Gedela ◽  
L. Annam ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Early Stage ◽  
Private Insurance ◽  
Locally Advanced ◽  
Cancer Center ◽  
Advanced Stage ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Time Distance

Background: There is a geographical, socioeconomical and logistic diversity among the cancer patients who reach a regional cancer center. In a developing economy like that of India's, only a minority of patients have medical insurance. So in our setup a cancer patient is met with time, distance and financial challenges. These intangible factors theoretically are expected to influence the ultimate outcome of cancer treatment. Aim: To evaluate the prevailing demographic and economic variables of cancer patients visiting our RCC and to look for any correlation among each other. Methods: The demographic details of cancer patients registered at our RCC between August 2017- September 2017 were retrieved retrospectively. Distance traveled to get to the RCC and get a diagnosis of cancer, time taken for diagnosis and initiation of treatment, and the source of finances for treatment were collected. A correlation among these factors was attempted to be identified. Statistical correlation was identified using Student t-test. Results: Among 591 patients who were analyzed, the median age of patient was 55 years old. The median time taken for the patient to reach the RCC from permanent residence after the beginning of cancer related complaints was 3.19 months. The median distance traveled for the same was 131 km. The source of income was private employment for 223 patients and government employment for 164 patients and self-employment for 200 patients. Only 164 patients had some kind of structured health scheme to manage their health care expenses. Among these, 96 patients had private insurance/reimbursement and 64 patients had government reimbursement. 384 (64%) of patients presented with advanced and locally advanced stage disease while 114 (19%) patients presented to us with early stage disease. However a correlation between delay in presentation to the RCC, distance traveled to reach the RCC, source of income and advanced stage of disease couldn't not be established. Conclusion: Majority of patients visiting our RCC is from far off places and most of these patients pay for the cancer treatment themselves without any support from government or private insurances. All these factors may be responsible for late or advanced stage presentation of cancer patients.

Prognosis for papillary serous carcinoma of the endometrium after surgical staging

2001 ◽  
Vol 11 (4) ◽  
pp. 305-311
Author(s):  
D. Semer ◽  
N. P. Nguyen ◽  
S. Sallah ◽  
U. Karlsson ◽  
P. Vos ◽  
...  
Keyword(s):  
Early Stage ◽  
Locally Advanced ◽  
Distant Metastases ◽  
Serous Carcinoma ◽  
Advanced Stage ◽  
Pattern Of Failure ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Papillary Serous Carcinoma ◽  
Abdominal Irradiation

Abstract.Nguyen NP, Sallah S, Karlsson U, Vos P, Ludin A, Semer D, Tait D, Salehpour M, Jendrasiak G, Robiou C. for papillary serous carcinoma of the endometrium after surgical staging.Background: To investigate the pattern of failure and the prognosis following pathological staging for uterine papillary serous carcinoma (UPSC).Patients and methods: A retrospective review was conducted of 22 patients with UPSC, treated between 1989 and 1998 at a single institution. All patients were surgically staged. Two patients with advanced disease received chemotherapy only. Two patients with early-stage disease were followed without further treatment. Eighteen patients received postoperative irradiation; eight patients received whole abdominal irradiation (WART), and the remaining 10 patients, pelvic irradiation (PRT). In addition, seven of these patients received vaginal cuff irradiation with low-dose-rate or high-dose-rate brachytherapy. Toxicity, pattern of failure, and survival were evaluated and compared to the literature.Results: Seven patients (32%) developed distant metastases, three out of seven (42%) after WART. Four out of seven patients who had distant metastases died from disease progression during subsequent chemotherapy. All patients with distant metastases had locally advanced-stage disease at presentation (six stage III, one stage IV). Four patients with pelvic recurrences developed concurrent (2) and subsequent (2) distant metastases. Three patients had isolated distant metastases. No patient with early stage-disease (stage I and II) died from disease progression.Conclusion: Pathological staging should be performed for all patients with UPSC to determine the prognosis as well as to tailor the treatment. The role of abdominal irradiation in the treatment of UPSC is yet to be determined; however, such an approach may not be necessary for the control of disease for patients with early-stage (I and II) disease. Patients with locally advanced-stage (stage III) disease are at risk of local regional failures and distant metastases despite WART. Therefore, the benefit of WART for advanced-stage disease is also questionable. Paclitaxel-based chemotherapy is currently being investigated in this setting.

Unmanipulated Bone Marrow Transplantation From Haploidentical Related Donor for Patients with High-Risk Hematological Malignancies

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2350-2350 ◽  
Author(s):  
Paolo Di Bartolomeo ◽  
Stella Santarone ◽  
Gottardo De Angelis ◽  
Alessandra Picardi ◽  
Pasqua Bavaro ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Hematological Malignancies ◽  
Bone Marrow Cells ◽  
Early Stage ◽  
Chronic Gvhd ◽  
Advanced Stage ◽  
Gvhd Prophylaxis ◽  
Related Donor ◽  
Marrow Cells

Abstract Abstract 2350 In this study we investigated the feasibility and clinical value of non T-cell depleted bone marrow transplantation (BMT) from HLA haploidentical related donor in patients with high risk hematological malignancies. Materials and Methods. Between August 2005 and May 2010, 71 patients were transplanted for acute myeloid leukemia (AML) (n=42), acute lymphoblastic leukemia (n=13), chronic myeloid leukemia (n=5), Hodgkin lymphoma (n=5), plasmacell leukemia (n=3), myelofibrosis (n=2) and myelodisplastic syndrome (n=1). Their median age was 35 years (5-71). At time of BMT, all patients were at very high risk: 39 were in early (complete remission 1 or 2) and 31 in more advanced stage of disease. Seventeen of them were given a previous transplant either autologous (n=14) or allogenic (n=3). All donors were HLA identical at 1 haplotype and mismatched for 2 (n=24) or 3 (n=47) loci on the unshared haplotype. As pretransplant regimen, 10 patients received a reduced intensity conditioning consisting of Fludarabine (Flu) alone (n=1), Flu + Thiotepa (Thio) + Melphalan (n=2) or Flu + Thio + i.v.Busulphan (Bu) (n=7), and 61 patients received a myeloablative therapy consisting of Aracytin + Cyclophosphamide combined with TBI (n=7) or Treosulphan (n=11) or Bu (n=11), whereas the last 32 consecutive patients underwent transplant after conditioning with the association of Thio + Flu + i.v. Bu. All patients received an identical graft-versus-host disease (GvHD) prophylaxis consisting of Fresenius Antithymocyte Globulin (5 mg/Kg/d from day -4 to -1) combined with Cyclosporine (1,5-3 mg/Kg/day i.v. from day -7 to +28 and orally 5 mg/Kg until day +365), Methotrexate (15 mg/sqm on day +1 and 10 mg/sqm on day +3, +6 and +11), Mycophenolate Mofetil (1 g/d from day +7 to +100) and the anti-CD 25 monoclonal antibody Basiliximab (20 mg i.v. on day 0 and +4). Bone marrow cells were harvested from all donors after priming with Filgrastim at 3–4 microg/Kg/d from day -7 to -1. Bone marrow cells were infused fresh and unmanipulated on day 0. Results. The median dose of total nucleated, CD34+ and CD3+ cells infused was 7.8 (1-28) ×108/kg, 2.1 (0.8-11) ×106/Kg and 28 (10-98) ×106/Kg, respectively. One patient had a primary graft failure and 5 patients died too early to be evaluated for engraftment. Results in terms of cumulative incidence (CI) of PMN engraftment, acute and chronic GvHD, relapse, transplant related mortality (TRM) and overall survival (OS) estimated with the Kaplan Meyer method are given in the Table. After a median follow-up of 16 (3-56) months, the 3 years probability of OS and disease-free survival (DFS) was 43% and 37% respectively for all patients (see Figure). The 3 years OS for the 42 patients with AML was 48% (61% for 30 patients transplanted in early stage and 18% for 12 patients transplanted in advanced stage, P=0.01). The 1 year OS for the 32 patients transplanted with the conditioning therapy employed in the last 2 years (Thio + Flu + i.v. Bu) was 72% in 18 patients transplanted in early stage and 52% in 14 patients transplanted in advanced stage (P=0.47). Conclusions. BMT from haploidentical donor using G-CSF primed, unmanipulated bone marrow cells and an intensive regimen for GVHD prophylaxis is correlated with high engraftment rate, low incidence of acute and chronic GVHD, acceptable TRM and favourable patient outcome. The results seem particularly encouraging for AML patients grafted at an early disease stage. In alternative to transplant from matched unrelated donor or cord blood, this approach can be offered to high risk patients with hematological malignancies particularly for those who are on urgency for a transplant. Results are given as % ± standard error Disclosures: No relevant conflicts of interest to declare.

Disparities in stage at presentation and treatment of colorectal cancer among Hispanic and non-Hispanic white patients.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 433-433 ◽  
Author(s):  
Rodrigo Rodriguez ◽  
Melissa Gonzalez ◽  
Bridget N. Fahy ◽  
Anita Kinney ◽  
Ashwani Rajput
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Locally Advanced ◽  
Incidence Rates ◽  
Cancer Center ◽  
Advanced Stage ◽  
Stage Of Disease ◽  
Nccn Guidelines ◽  
Significant Difference

433 Background: Although incidence rates for colorectal cancer (CRC) for Hispanics are similar to non-Hispanic whites (NHW) in New Mexico, the cause-specific mortality is higher among the Hispanic population. Hispanics have also been shown to be less likely to be current with colorectal cancer screening guidelines as compared to NHW. The purpose of this study was to determine if there was a difference between Hispanics and NHW in stage at presentation and if the care provided was concordant with NCCN guidelines at our NCI designated cancer center. Methods: A prospective data base of all patients who presented with colorectal cancer between June 2009 and July 2013 was queried. A total of 197 patients were identified. Data was extracted that included: demographics, stage of CRC at first diagnosis, treatments given, and pathology results. Frequencies of stage at presentation and NCCN guideline concordance (meeting the 12 lymph node metric, receipt of adjuvant therapy for stage III disease and radiation therapy for locally advanced rectal cancer) were recorded. Results: The Table shows the results. There were 107 (55%) males. There was not a statistical difference in the stage of presentation for Hispanics and NHW for patients with colon cancer. Hispanic patients with rectal cancer, however, presented with more advanced stage of disease as compared to NHW (p<0.05). There was no statistically significant difference in concordance with NCCN guidelines for the three metrics analyzed. Conclusions: Hispanics and NHW with colon cancer presented with similar stage of disease and were concordant with NCCN guideline metrics. Hispanics with rectal cancer, however, presented at a more advanced stage of disease as compare to NHW patients. The reason for this disparity remains to be elucidated. Future studies to include outreach, education, screening and molecular profiling of these disparate populations are planned. [Table: see text]

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