COLON-CANCER IN BLACKS - AGE-RELATED PRESENTATION AND SURVIVAL WITHINA SIMILAR SOCIOECONOMIC GROUP

Young blacks with colon cancer continue to have a poor survival rate f or reasons that remain undetermined. Medical records of blacks with co lon cancer diagnosed at an inner-city hospital during a 10-year period were reviewed. The cohort consisted of 118 indigent, nonmigratory pat ients grouped by age. Group 1 consisted of 11 patients under age 50, a nd group 2 consisted of 107 patients age 50 and over. Admission sympto ms were significantly different between groups. Patients in group 1 pr esented with abdominal pain more often than patients in group 2, and n one of the patients in group 1 had anemia or obstruction, which compri sed 14% and 11%, respectively, of the presenting symptoms in group 2 p atients. Overall, survival difference was significant; the survival ra te was 22.8 months for group 1 and 64.2 months for group 2 (P<.02). Th ere was no difference in stage at presentation to account for the decr eased survival in group 1. It is possible that the overwhelming majori ty (45%) of patients in group 1 with abdominal pain actually had more virulent disease, which accounts for the short survival. These individ uals must be targeted for more aggressive patient education, surveilla nce, early detection and treatment, and follow-up.