Young African-Americans with Colon Cancer Fare Worse

Racial disparities in treatment outcomes for young colon cancer patients appear at every stage of the disease, data show, suggesting screening access isn’t all that matters.

4:19 PM

Author | Nicole Fawcett

Both age and race impact colorectal cancer survival, a new study finds.

African-Americans diagnosed with colorectal cancer at a young age had significantly worse outcomes compared with young white or Hispanic patients.

The number of colorectal cancer diagnoses in patients younger than 50 is increasing, challenging the notion that colorectal cancer is a disease of aging. A recent study found that nearly 15 percent of colorectal cancers were diagnosed before 50.

Little is known about what's happening at the molecular level with these tumors in younger patients. Researchers think these young-onset cancers may be biologically different from the type of tumor that occurs in older people.

Meanwhile, racial disparities in colorectal cancer survival have worsened overall since 2000.

"There are differences between the races, and there may be differences in younger patients," says study author Elena Stoffel, M.D., director of the Cancer Genetics Clinic at the University of Michigan Rogel Cancer Center. "We need to look at tumors that develop in young people and in African-Americans to see if they have molecular differences compared to the typical colorectal cancer seen in older adults."

We need to look more carefully at how we're treating colorectal cancers in young people.
Elena Stoffel, M.D.

Disparities due to more than preventive care

The study, published in the Journal of Clinical Oncology, reviewed 28,145 patients diagnosed with colorectal cancer before age 50. Patient information was gathered from the National Cancer Institute's Surveillance, Epidemiology and End Results database of cancer incidence.

Five-year survival was significantly worse at every stage of the disease for African-American patients than for white or Hispanic patients.

In particular, the researchers found that young African-Americans with stage 2 colon cancer have a 60 to 70 percent higher risk of death compared with young white patients. Previous studies have shown disparities are more pronounced in advanced disease.

Many in the research community have attributed racial disparities in colorectal cancer to access to screening. Colorectal cancer screening guidelines recommend starting the tests at age 50. By looking at patients too young to undergo such tests, this new study takes access to screening off the table as a factor in disparities.

Stoffel says she was surprised to see a significant difference in survival among stage 2 cancer cases, which are usually associated with very good prognosis when treated with surgery alone without chemotherapy. Previous studies suggest that patients with stage 2 colon cancer receive minimal, if any, benefit from chemotherapy. But these studies included mostly patients diagnosed at older ages. Oncologists tend to be more likely to offer chemotherapy to young patients, which suggests the possibility that differences in cancer treatment are causing a disparity.

"This is a group for which treatment should make the least difference, and yet we see the biggest disparities in survival," Stoffel says.

"The fact we're seeing a big disparity in outcomes in young people with stage 2 disease suggests that early stage tumors may behave differently in different patients. We need to look more carefully at how we're treating colorectal cancers in young people. If these cancers are molecularly different from your average older-onset cancers, then perhaps they respond differently to treatment."


More Articles About: Lab Report Colon Cancer Cancer: Cancer Types
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories DNA helix technology robotic cybernetic image
Health Lab
Metabolite tells cells whether to repair DNA
Findings from researchers at the University of Michigan Health Rogel Cancer Center, published in Cancer Discovery, show how a specific nucleotide metabolite called GTP controls responses to radiation and chemotherapy in an unexpected way.
Doctors with patient while on exam table
Health Lab
Can personalized care prevent overscreening for colorectal cancer in older adults?
Study reveals presenting adults between 76 and 85 with personalized information about the benefits and harms of colon cancer screening decreases excess screening
cancer cell yellow blue
Health Lab
Potato starch supplements could be solution to bone marrow transplant complications
University of Michigan Health Rogel Cancer Center scientists have found a potential solution for preventing a common and dangerous complication in patients that receive stem cell transplants from a donor’s blood or bone marrow.  
older person pouring pills into hand close up
Health Lab
Early findings suggest this cancer drug may be effective against advanced tumors caused by genetic mutations
Sparrow Health System, part of University of Michigan Health, experts release findings in a study of a cancer drug for patients with genetic mutations.
Health Lab
Tumor-destroying soundwaves receive FDA approval for liver treatment in humans
Michigan Medicine has developed a new technique that provides a non-invasive alternative to surgery, chemotherapy and radiation treatments for cancer.
surgeons in operating room
Health Lab
A unique approach to transplantation for liver malignancies
A Michigan Medicine transplant specialist examines different ways of caring for patients with liver cancer.