Survival Trend in Colorectal Cancer in African American Patients Over the Last Decades
Tarik Wasfie, Vihangi Niyangoda, Hemal Dholakia, Erica Roach, Harold Freeman
African American (AA) patients with colorectal cancer (CRC) had a lower survival rate than white
Caucasians (WC) regardless of the stages of the disease. To follow the trend in survival over the years,
we look at data on our CRC survival during 1963-1985 and followed the current published data on CRC
survival.
This is a retrospective analysis of patients with colorectal cancer seen in an inner-city teaching hospital
serving mostly AA populations between 1963-1985. Data collected and analyzed were age, sex, race,
insurance carriers, stage of cancer at presentation to treatment, treatment provided, and survival rate
at 5 and 10 years.
There were a total of 803 patients. Of those, 754 (94%) patients were African American with the mean
age of the group being 68 years. Females made up 56% of the sample population and with 47% of the
patients presented with rectal bleeding and bowel obstruction. Thirty-two percent of these patients were
uninsured. Only 634 patients went for surgery with or without chemoradiation therapy. The TNM stages
were as follows: stage 1-16%, stage 2=21%, stage 3=30%, and stage 4=32%. Of the 635 patients
treated, 96 (15%) patients were lost to follow-up, and the five-year survival rate was 16%, and the 10-
year survival rate was 7%. Recent published data showed the five-year survival rate from colon cancer
improved slightly among AA diagnosed in early 2000 with CRC but has not reached the level of that
of white patients in both male and female (AA male 22.7 and female 14.8 versus white male 15.8 and
female 11.3, per 100,000 with p-value less than 0.001).
These findings suggest that disparities in survival between AA patients with colorectal cancer remain
high compared to WC, despite the efforts to close the differences by increased screening and improved
accessibility to healthcare services. Therefore, we should develop additional strategies to close the gap.
