Higher Colon-Cancer Mortality Rates Among Blacks Appear Related to Deaths Among Those Under Age 50

BUFFALO, N.Y. -- A new study from the University at Buffalo and Meharry Medical College indicates that the difference in colon-cancer mortality rates between blacks and whites may be due partly to the fact that young blacks appear to develop a more virulent form of colon cancer, and die sooner, than blacks who get the disease later in life.

A team of researchers analyzed medical records of blacks diagnosed with colon cancer at an inner-city hospital over 10 years.

The results, reported in the Journal of the National Medical Association, showed that blacks who developed colon cancer before the age of 50 lived only 30 percent as long as blacks who got the disease later in life, even though the younger patients' cancers were no further advanced when diagnosed. Average survival for the younger group was 22.8 months, compared to 64.5 months for the older group.

The research team, led by Harvey L. Bumpers, M.D., UB assistant professor of surgery, undertook the analysis to try to shed new light on why colon-cancer survival rates are increasing for whites but not for blacks.

"Such a dramatic difference in survival noted in this study certainly suggests that young black patients with colon cancer may account largely for the survival differences between the races," Bumpers stated. Colon cancer usually occurs in people over 50.

Earlier detection may be an important key to achieving a survival rate among blacks comparable to whites, Bumpers said, because colon-cancer patients have a better prognosis if the disease is detected before there are symptoms.

Earlier studies have identified low socioeconomic status as a risk factor for many cancers, including colon cancer, and have suggested a role for environment, dietary habits and genetics. This study was done to determine the impact of age on colon-cancer survival rates in a low socioeconomic population.

The team reviewed the records of 118 black patients diagnosed with colon cancer between 1971 and 1981. Eleven patients were less than 50 years old, 107 were in the 50-plus age group. The researchers reviewed the records for symptoms, stage of the disease, tumor structure and location.

The younger cancer patients presented different symptoms than the older patients at their initial diagnosis.

Nearly half of the younger group had abdominal pain, compared with only 23 percent of the older patients. The younger group showed no signs of bowel obstruction and anemia, symptoms evident in 10 percent and 14 percent, respectively, of the older group.

The researchers concluded that, for reasons yet to be determined, colon cancer in young blacks appears to be particularly virulent.

They recommend more aggressive patient education, surveillance, early detection, treatment, and follow-up of people at increased risk for colon cancer in this low socioeconomic group.

Authors of the study, in addition to Bumpers, are James M. Hassett, Jr., M.D.; Ralph Doerr, M.D.; W. Lynn Weaver, M.D., and Eddie Hoover, M.D., from the UB Department of Surgery, and Wydell L. Williams, Jr., M.D.; Patricia Weaver, M.D.; Bernard S. Harrison, M.D., and Sydney Barnwell, M.D., from Meharry Medical College.