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Ann Epidemiol. 2011 Dec;21(12):914-21. doi: 10.1016/j.annepidem.2011.09.002. Epub 2011 Oct 13.

Predictors of delayed-stage colorectal cancer: are we neglecting critical demographic information?

Author information

1
Department of Epidemiology & Biostatistics, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA. john.w.morgan@att.net

Abstract

PURPOSE:

We sought to distinguish roles of demographic variables and bowel segments as predictors of delayed versus early stage colorectal cancer in California.

METHODS:

Demographic and anatomic variables for 66,806 colorectal cancers were extracted from the California Cancer Registry for 2004-2008 and analyzed using logistic regression as delayed versus early stage.

RESULTS:

Odds ratios (OR) for binary stage categories comparing age <40 (OR=2.58; 95% CI=2.26-2.94), 40-49 (1.71; 95%=1.60-1.83) and 75+ (1.05; 1.02-1.09) relative to 50-74 years were computed. Compared with non-Hispanic whites, ORs for stage categories were: 1.05; 0.99-1.13 (non-Hispanic blacks), 1.08; 1.02-1.13 (Hispanics), and 1.05; 1.00-1.10 (Asian/others). Females had higher odds of delayed diagnosis (1.09; 1.06-1.13) than males. Descending ORs were measured for successively lower to highest socioeconomic status (SES) quintiles (OR 4:5=1.08; 1.03-1.14, OR 3:5=1.13; 1.08-1.19, OR 2:5=1.18; 1.12- 1.24, and OR 1:5=1.21; 1.14-1.28).

CONCLUSIONS:

Younger and older than age 50-74; females; Hispanic ethnicity; bowel segment contrasts (right/left, proximal/distal, cecum plus appendix/distal), and lower SES were independent predictors of delayed diagnosis. Low SES was the most robust predictor of delayed diagnosis, independent of other covariates. Approximately 77% of delayed diagnoses were in non-Hispanic whites and Asian/others. These findings illustrate the value of a community SES index for targeting egalitarian colorectal cancer screening.

PMID:
22000327
DOI:
10.1016/j.annepidem.2011.09.002
[Indexed for MEDLINE]
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