학술논문

Late Presentation of Colorectal Cancer in a Vulnerable Population
Document Type
article
Source
The American Journal of Gastroenterology. 108(4)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Oncology and Carcinogenesis
Colo-Rectal Cancer
Cancer
Health Services
Prevention
Clinical Research
Digestive Diseases
Detection
screening and diagnosis
Aetiology
4.4 Population screening
2.4 Surveillance and distribution
Good Health and Well Being
Aged
Cohort Studies
Colorectal Neoplasms
Early Detection of Cancer
Ethnicity
Female
Humans
Kaplan-Meier Estimate
Male
Medically Uninsured
Middle Aged
Neoplasm Staging
Proportional Hazards Models
SEER Program
San Francisco
Survival Rate
Vulnerable Populations
Ethnic Groups
Gastroenterology & Hepatology
Clinical sciences
Language
Abstract
ObjectivesWe examined colorectal cancer (CRC) stage at presentation and mortality in a vulnerable population compared with nationally representative data.MethodsCRC cases were identified from San Francisco General Hospital (SFGH) and the Surveillance Epidemiology and End Results (SEER) database.ResultsFifty-five percent of the SFGH cohort presented with advanced disease, compared with 44% of the SEER cohort. Increased risk of advanced stage at presentation at SFGH compared with SEER was most evident among blacks and Asians. There was weak evidence for worse survival at SFGH compared with SEER overall. This varied by race with poorer survival at SFGH among whites and possibly blacks but some evidence for better survival among Asians. Among CRC patients at SFGH, Asians and Hispanics had better survival than whites and blacks. At SFGH, 44% had a diagnosis of CRC within 1 year of establishing care there. Of those who had established care at SFGH for at least 1 year, only 22% had exposure to CRC screening tests.ConclusionsThese findings allow examination of CRC presentation by ethnicity in vulnerable populations and identify areas where access and utilization of CRC screening can be improved.