Geographic Location Affects Stage at Diagnosis of Colon Cancer in Segregated Communities

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People living among their same ethnicity often have a lower risk of late-stage disease at diagnosis.
People living among their same ethnicity often have a lower risk of late-stage disease at diagnosis.

In segregated communities, the geographic region in which a person lives influences disease stage at diagnosis among persons with colorectal cancer. The timing of cancer diagnosis significantly affects prognosis, with later-stage diagnoses resulting in disease that is more difficult to treat.1

Research suggested patients living in highly segregated Asian communities, primarily in coastal California, are relatively more likely to have late-stage colorectal cancer at diagnosis, whereas patients living in highly segregated African American communities, primarily in large urban areas and the Sun Belt, are less likely have late-stage disease at diagnosis.

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This study also revealed that people living in segregated locations among their same race or ethnicity receive a slightly protective effect, with a lower risk of late-stage disease at diagnosis. Perhaps these segregated locations offer cohesive community in which encouragement to be screened is more prevalent.

Colorectal cancer is second to lung cancer. Screening for colorectal cancer can effectively identify and excise precancerous tissue before the disease progresses to more advanced stages with worse prognoses.

Researchers assessed data from the United States Cancer Statistics database, which is run by the Centers for Disease Control and Prevention. The analyzed data focused on more than 500,000 cases of colorectal cancer newly diagnosed between 2004 and 2009.

Additionally, researchers executed a literature review, revealing examples of multiple campaigns to promote urban populations to undergo colorectal cancer screenings. These campaigns were targeted particularly to minority, low-income, and non-English speaking sections of urban populations.

The study discovered far fewer campaigns targeting rural populations and no campaigns targeting Asian Americans. The authors suggested that campaign efforts encouraging screening should focus on the San Francisco Bay area, where a relatively high rate of late stage diagnosis was revealed.


1. Mobley LR, Scott L, Rutherford Y, Kuo TM. Using residential segregation to predict colorectal cancer stage at diagnosis: two different approaches. Ann Epidemiol. 2016 Nov 25. doi: 10.1016/j.annepidem.2016.11.008. [Epub ahead of print]

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