Racial/ethnic differences in colorectal cancer risk: The multiethnic cohort study
Open Access
- 2 December 2010
- journal article
- research article
- Published by Wiley in International Journal of Cancer
- Vol. 129 (8), 1899-1906
- https://doi.org/10.1002/ijc.25822
Abstract
Incidence rates in the United States show clear racial/ethnic disparities for colorectal cancer. We examined the extent to which ethnic differences in risk factors could explain the age‐adjusted variation in the risk of colorectal cancer, overall and by stage at diagnosis, among 165,711 African Americans, Japanese Americans, Latinos, Native Hawaiians and whites participating in the Multiethnic Cohort Study. Over a median follow‐up period of 10.7 years, 2,564 incident cases of colorectal cancer were identified through surveillance, epidemiology and end result tumor registry linkages in Hawaii and California. Multivariable‐adjusted Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) for each ethnic group compared to whites. After accounting for known/suspected risk factors, Japanese Americans (men, RR = 1.27, 95% CI = 1.09–1.48; women, RR = 1.49, 95% CI = 1.24–1.78) and African American women (RR = 1.48, 95% CI = 1.23–1.79) remained at increased risk of colorectal cancer relative to whites; African American and Japanese American women were also at increased risk of advanced disease compared to whites. In site‐specific analyses, after multivariable adjustment, African Americans (both sexes) and Japanese American women remained at increased risk for colon cancer, and Japanese Americans (both sexes) and Native Hawaiian men for rectal cancer compared to whites. The results of our study suggest that differences in the distribution of known/suspected risk factors account for only a modest proportion of the ethnic variation in colorectal cancer risk and that other factors, possibly including genetic susceptibility, are important contributors to the observed disparities in incidence.This publication has 14 references indexed in Scilit:
- Annual report to the nation on the status of cancer, 1975‐2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future ratesCancer, 2009
- Colorectal cancer incidence in the United States, 1999‐2004Cancer, 2009
- Flavonols and Pancreatic Cancer Risk: The Multiethnic Cohort StudyAmerican Journal of Epidemiology, 2007
- Cancers of the Colon and RectumPublished by Oxford University Press (OUP) ,2006
- Migrant StudiesPublished by Oxford University Press (OUP) ,2006
- Demographics and tumor characteristics of colorectal cancers in the United States, 1998–2001Cancer, 2006
- Ethnic and Racial Differences in the Smoking-Related Risk of Lung CancerThe New England Journal of Medicine, 2006
- Differences in colorectal carcinoma stage and survival by race and ethnicityCancer, 2005
- A Multiethnic Cohort in Hawaii and Los Angeles: Baseline CharacteristicsAmerican Journal of Epidemiology, 2000
- Colorectal cancer incidence in Asian migrants to the United States and their descendantsCancer Causes & Control, 2000