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Higher rates of colorectal cancer incidence and mortality experienced by African-Americans may be driven largely by differences in health care utilization, and less by biology, according to a new study led by researchers from the National Cancer Institute (NCI), part of the National Institutes of Health.
In a study involving more than 60,000 people who were screened for colorectal cancer, researchers found that blacks and whites were equally likely to need a follow-up colonoscopy after a screening sigmoidoscopy, but blacks were less likely to actually receive the follow-up.
Lower rates of follow-up could lead to delayed diagnosis and treatment and higher mortality. The results of this study were published online April 6, 2010, in the Journal of National Cancer Institute (JNCI) and will appear in the April 21, 2010, print edition.
"Our research suggests that the biology of colorectal cancer may not differ by race, at least in the early stages of tumor development," said author Adeyinka O. Laiyemo, M.D., M.P.H., from NCI's Division of Cancer Prevention. "Instead, health care utilization differences among races may play a more important role in colorectal cancer disparities."
In the United States, colorectal cancer disproportionally affects blacks, who have higher incidence and mortality rates compared to whites. From 2002 to 2006, the average annual incidence rate for colorectal cancer was 48.6 per 100,000 for white men and women combined, compared to 59.9 per 100,000 for black men and women. The annual mortality rates for the same time period were 17.7 per 100,000 for white men and women, and 25.4 per 100,000 for black men and women. Several studies have found that blacks are more likely than whites to be diagnosed with advanced colorectal cancer, which is more difficul
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NIH/National Cancer Institute