The relationship between ethnicity,social deprivation and late presentation of colorectal cancer |
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| Institution: | 1. Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark’s Hospital & Academic Institute, Harrow, Middlesex, HA1 3UJ, United Kingdom;2. Department of Gastroenterology, St Mark’s Hospital, Harrow, Middlesex, HA1 3UJ, United Kingdom;3. Imperial College London, United Kingdom;4. Department of Surgery and Cancer, Imperial College, United Kingdom;5. Faculty of Medicine, School of Public Health, Dr Foster Unit, Imperial College London, United Kingdom;1. Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Japan;2. Hokkaido Urothelial Cancer Research Group, Sapporo, Japan;1. Department of Preventive and Predictive Medicine, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;2. Epidemiology and Biostatistics Unit, CRO Aviano National Cancer Institute IRCCS, Aviano, Italy;3. Division of Radiation Oncology 1, Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;4. Urological Surgical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;1. Cancer Epidemiology & Health Services Research Group, Centre for Public Health, Queen''s University Belfast, Northern Ireland, UK;2. Centre for Cancer Research and Cell Biology, Queen''s University Belfast, Northern Ireland, UK;3. Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Northern Ireland, UK;4. Department of Cellular Pathology, Queen''s Medical Centre, Nottingham University Hospitals NHS Trust, UK;5. The John van Geest Cancer Research Centre, Nottingham Trent University, Clifton Lane, Nottingham NG11 8NS, UK;1. Quantify Research, Hantverkargatan 8, 112 21 Stockholm, Sweden;2. Amgen Inc., Center for Observational Research, South San Francisco, CA, United States;3. Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden;4. Department of Public Health and Caring Sciences, Uppsala University, 751 22 Uppsala, Sweden;5. Amgen Inc., Center for Observational Research, One Amgen Center Drive 24-2-A, Thousand Oaks, CA 91320, United States;6. IMS Health/Pygargus, Sveavägen 155, 113 46 Stockholm, Sweden;7. LIME/Medical Management Centre, Karolinska Institute, 171 77 Stockholm, Sweden;8. Uppsala University, 751 05 Uppsala, Sweden;1. University hospital of Martinique, oncology haematology urology pathology department, UF 1441 cancer research and registry, 97261 Fort-de-France, Martinique;2. University hospital of Martinique, oncology haematology urology pathology department, 97261 Fort-de-France, Martinique;3. AMREC, 97232 Fort-de-France, Martinique;4. Laboratoire de pathologie SERAL, 97233 Fort-de-France, Martinique;5. University of French West Indies, EA 929-Biosphères, 97157 Fort-de-France, Martinique;1. School of Health Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK;2. Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK;3. Centre for Health and Population Sciences, Hull York Medical School, Hull HU6 7RX, UK;4. Unit of Social and Behavioural Sciences, King’s College London Dental Institute, London SE5 9RW, UK |
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| Abstract: | IntroductionTumour staging at time of presentation is an important factor in determining survival in colorectal cancer. The aim of this paper is to investigate the relationship between ethnicity and deprivation in late (Stage IV) presentation of colorectal cancer.MethodsData from the Thames Cancer Registry comprising 77,057 colorectal cancer patients between the years 2000 and 2012 were analysed.ResultsA total of 17,348 patients were identified with complete data, of which 53.9% were male. Patients from a Black Afro/Caribbean background were diagnosed with CRC at a much younger age than the White British group (median age 67 compared with 72, p < 0.001). In multiple regression, ethnicity, deprivation and age were positive predictors of presenting with advanced tumour stage at time of diagnosis. Black patients were more likely to present with Stage IV tumours than white patients (OR 1.37, 95% CI 1.18–1.59, p < 0.001). Social deprivation was also a predictor of Stage IV cancer presentation, with the most deprived group (Quintile 5) 1.26 times more likely to be diagnosed with Stage IV cancer compared with the most affluent group (CI 1.13–1.40, p < 0.001). Sub-group analyses demonstrated that Black & Affluent patients were still at greater risk of Stage IV CRC than their White & Affluent counterparts (OR 1.24, 95% CI 1.11–1.45, p = 0.023). Patients with rectal cancer were less likely to present with Stage IV CRC (OR 0.66, 95% CI 0.61–0.71, p < 0.001).ConclusionRacial and age related disparities exist in tumour presentation in the United Kingdom. Patients from black and socially deprived backgrounds as well as the elderly are more likely to present with advanced tumours at time of diagnosis. |
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| Keywords: | Colorectal cancer Ethnicity Social deprivation Age |
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