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Colon cancer is the third leading cause of death from cancer in the United States. Recent studies report on increasing proportions of proximal cancers. The etiology behind this epidemiological trend is unclear, and its implication on survival outcomes is unknown. Further analysis of the impact of anatomic site of disease among a large multiethnic population will help facilitate research and education to improve colon cancer screening and treatment.
To investigate the association between proximal tumor location and survival in patients with colon cancer. DESIGN AND
A large retrospective cohort study in the US utilizing the Surveillance, Epidemiology, and End Results (SEER) cancer registry analyzed survival outcomes of patients with colon cancer. Multivariable logistic regression analyses investigated sex-specific, race/ethnicity-specific, and anatomic site-specific disparities in survival. MAIN
Five-year survival outcomes from colon cancer.
Our study demonstrated significant disparities in survival by sex, race/ethnicity, and anatomic site. Across all time periods and among most cohorts, patients with proximal cancers had significantly worse survival outcomes. When compared to distal cancers, patients with proximal cancers were 13% less likely to survive 5 years (OR 0.87; 95% CI, 0.82-0.91). When compared to non-Hispanic whites, blacks were 30% less likely to survive 5 years (OR 0.70; 95% CI, 0.68-0.73). Stage-specific multivariable regression analysis of localized cancers demonstrated similar findings.
Significant race-specific, sex-specific, and anatomic site-specific disparities in colon cancer survival exist. Proximal cancers are associated with worse survival odds. These disparities may reflect differences in the genotype and phenotype of colon cancer among these groups. A modified risk assessment tool that incorporates these variations may be more effective in the early detection and treatment of colon cancer.
Department of Medicine, California Pacific Medical Center, 2351 Clay Street, Suite 380, San Francisco, CA, 94115, USA, RobertWong123@gmail.com.
This article was published in the following journal.
Name: Journal of general internal medicine
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Tumors or cancer of the COLON.
Tumors or cancer of the COLON or the RECTUM or both. Risk factors for colorectal cancer include chronic ULCERATIVE COLITIS; FAMILIAL POLYPOSIS COLI; exposure to ASBESTOS; and irradiation of the CERVIX UTERI.
Tumors or cancer of the SIGMOID COLON.
The artery supplying nearly all the left half of the transverse colon, the whole of the descending colon, the sigmoid colon, and the greater part of the rectum. It is smaller than the superior mesenteric artery (MESENTERIC ARTERY, SUPERIOR) and arises from the aorta above its bifurcation into the common iliac arteries.
The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON.
Colon or Colorectal cancer is the growth of malignant polyps on the colon, bowel, anus and rectum. Growths in these locations can be benign, and removed by colonoscopy, but they have a risk of becoming malignant. About 10 per cent of bowel cancer...
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Proximal Ascending Colon Cancermass in the proximal ascending colonproximal transverse colonimages of proximal colonimages of proximal colonconjestion in the proximal ascending colonproximal colon cancerlesion in the proximal ascending colonproximal colon cancers PROXIMAL COLONproximal transverse colon cancerproximal ascending colonproximal rectal cancerProximal Ascending Colon Polypis a tumor worse in the ascending colon