Racial differences in the incidence of colorectal cancer
R Virk, S Gill, E Yoshida, S Radley, B Salh
BACKGROUND: Colon cancer is one of the most common cancers
and the second most common cause of cancer mortality in Western
societies. Population screening has been introduced as a means to
reducing its impact; however, there are little or no data on the incidence
of this disorder in the different populations that comprise the
Canadian population.
OBJECTIVE: To retrospectively determine the incidence of colorectal
cancer in selected racial populations of British Columbia.
METHODS: The British Columbia Cancer Agency database was used
to retrieve information on the incidence of cancers occurring during
the years 1994 to 1998, with the British Columbia and national population
censuses used to derive the age-specific and age-standardized
incidence rates of colorectal cancers. Surnames were used to identify
the origin of individuals from South Asian and Chinese backgrounds.
RESULTS: For the Caucasian Canadian (C) population, the weighted
age-standardized incidence rate ranged from 51.99 per 100,000 in
1995, to 57.68 per 100,000 in 1998. For Chinese Canadians (CC), the
range was 39.2 per 100,000 in 1996, to 31.2 per 100,000 in 1998. For
South Asian Canadians (SAC), the range was 7.40 per 100,000 in
1994, to 24.85 per 100,000 in 1998. The RR for the development of
cancer were significantly different when comparing C versus CC (RR
1.9; 95% CI 1.58 to 2.31; P<0.001), C versus SAC (RR 7.1; 95% CI
4.20 to 12.0; P<0.0001) and CC versus SAC (RR 3.7; 95% CI 2.14 to
6.5; P<0.0001).
CONCLUSIONS: Significant differences in the incidence of colorectal
cancers have been defined for the first time in various racial subgroups
in British Columbia. This finding may have important
implications for both screening and understanding of the environmental
factors influencing the biology of these lesions. Because SAC
have among the highest incidence of atherosclerotic heart disease
and diabetes, it suggests that unidentified genetic and/or environmental
protective factors are capable of countering the traditionally recognized
risk of high saturated fat intake for the development of
colorectal cancer.
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