Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study

Rosa M. Xicola, Molly Gagnon, Julia R. Clark, Timothy Carroll, Weihua Gao, Christian Fernandez, Dragana Mijic, James B. Rawson, Ashley Janoski, Cenk K. Pusatcioglu, Priyanka Rajaram, Adam B. Gluskin, Maureen Regan, Vivek Chaudhry, Herand Abcarian, Jennifer Blumetti, Jose Cintron, Joshua Melson, Hui Xie, Grace GuzmanRajyasree Emmadi, Victoria Alagiozian-Angelova, Sonia S. Kupfer, Carol Braunschweig, Nathan Ellis, Xavier Llor

Research output: Contribution to journalArticle

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Abstract

Purpose: African Americans (AA) have the highest incidence of colorectal cancer compared with other U.S. populations and more proximal colorectal cancers. The objective is to elucidate the basis of these cancer disparities.

Experimental design: Of note, 566 AA and 328 non-Hispanic White (NHW) colorectal cancers were ascertained in five Chicago hospitals. Clinical and exposure data were collected. Microsatellite instability (MSI) and BRAF (V600E) and KRAS mutations were tested. Statistical significance of categorical variables was tested by the Fisher exact test or logistic regression and age by the Mann-Whitney U test.

Results: Over a 10-year period, the median age at diagnosis significantly decreased for both AAs (68-61; P < 0.01) andNHWs(64.5- 62; P= 0.04); more AA patients were diagnosed before age 50 thanNHWs(22% vs. 15%; P = 0.01). AAs had more proximal colorectal cancer than NHWs (49.5% vs. 33.7%; P < 0.01), but overall frequencies of MSI, BRAF and KRAS mutations were not different nor were they different by location in the colon. Proximal colorectal cancers often presented with lymphocytic infiltrate (P < 0.01) and were diagnosed at older ages (P = 0.02). Smoking, drinking, and obesity were less common in this group, but results were not statistically significant.

Conclusions: Patients with colorectal cancer have gotten progressively younger. The excess of colorectal cancer in AAs predominantly consists of more proximal, microsatellite stable tumors, commonly presenting lymphocytic infiltrate and less often associated with toxic exposures or a higher BMI. Younger AAs had more distal colorectal cancers than older ones. These data suggest two different mechanisms driving younger age and proximal location of colorectal cancers in AAs.

Original languageEnglish (US)
Pages (from-to)4962-4970
Number of pages9
JournalClinical Cancer Research
Volume20
Issue number18
DOIs
StatePublished - Sep 15 2014

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African Americans
Microsatellite Repeats
Colorectal Neoplasms
Microsatellite Instability
Mutation
Poisons
Nonparametric Statistics
Drinking
Neoplasms
Colon
Research Design
Obesity
Logistic Models
Smoking
Incidence
Population

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Xicola, R. M., Gagnon, M., Clark, J. R., Carroll, T., Gao, W., Fernandez, C., ... Llor, X. (2014). Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study. Clinical Cancer Research, 20(18), 4962-4970. https://doi.org/10.1158/1078-0432.CCR-14-0353

Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study. / Xicola, Rosa M.; Gagnon, Molly; Clark, Julia R.; Carroll, Timothy; Gao, Weihua; Fernandez, Christian; Mijic, Dragana; Rawson, James B.; Janoski, Ashley; Pusatcioglu, Cenk K.; Rajaram, Priyanka; Gluskin, Adam B.; Regan, Maureen; Chaudhry, Vivek; Abcarian, Herand; Blumetti, Jennifer; Cintron, Jose; Melson, Joshua; Xie, Hui; Guzman, Grace; Emmadi, Rajyasree; Alagiozian-Angelova, Victoria; Kupfer, Sonia S.; Braunschweig, Carol; Ellis, Nathan; Llor, Xavier.

In: Clinical Cancer Research, Vol. 20, No. 18, 15.09.2014, p. 4962-4970.

Research output: Contribution to journalArticle

Xicola, RM, Gagnon, M, Clark, JR, Carroll, T, Gao, W, Fernandez, C, Mijic, D, Rawson, JB, Janoski, A, Pusatcioglu, CK, Rajaram, P, Gluskin, AB, Regan, M, Chaudhry, V, Abcarian, H, Blumetti, J, Cintron, J, Melson, J, Xie, H, Guzman, G, Emmadi, R, Alagiozian-Angelova, V, Kupfer, SS, Braunschweig, C, Ellis, N & Llor, X 2014, 'Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study', Clinical Cancer Research, vol. 20, no. 18, pp. 4962-4970. https://doi.org/10.1158/1078-0432.CCR-14-0353
Xicola, Rosa M. ; Gagnon, Molly ; Clark, Julia R. ; Carroll, Timothy ; Gao, Weihua ; Fernandez, Christian ; Mijic, Dragana ; Rawson, James B. ; Janoski, Ashley ; Pusatcioglu, Cenk K. ; Rajaram, Priyanka ; Gluskin, Adam B. ; Regan, Maureen ; Chaudhry, Vivek ; Abcarian, Herand ; Blumetti, Jennifer ; Cintron, Jose ; Melson, Joshua ; Xie, Hui ; Guzman, Grace ; Emmadi, Rajyasree ; Alagiozian-Angelova, Victoria ; Kupfer, Sonia S. ; Braunschweig, Carol ; Ellis, Nathan ; Llor, Xavier. / Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study. In: Clinical Cancer Research. 2014 ; Vol. 20, No. 18. pp. 4962-4970.
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abstract = "Purpose: African Americans (AA) have the highest incidence of colorectal cancer compared with other U.S. populations and more proximal colorectal cancers. The objective is to elucidate the basis of these cancer disparities.Experimental design: Of note, 566 AA and 328 non-Hispanic White (NHW) colorectal cancers were ascertained in five Chicago hospitals. Clinical and exposure data were collected. Microsatellite instability (MSI) and BRAF (V600E) and KRAS mutations were tested. Statistical significance of categorical variables was tested by the Fisher exact test or logistic regression and age by the Mann-Whitney U test.Results: Over a 10-year period, the median age at diagnosis significantly decreased for both AAs (68-61; P < 0.01) andNHWs(64.5- 62; P= 0.04); more AA patients were diagnosed before age 50 thanNHWs(22{\%} vs. 15{\%}; P = 0.01). AAs had more proximal colorectal cancer than NHWs (49.5{\%} vs. 33.7{\%}; P < 0.01), but overall frequencies of MSI, BRAF and KRAS mutations were not different nor were they different by location in the colon. Proximal colorectal cancers often presented with lymphocytic infiltrate (P < 0.01) and were diagnosed at older ages (P = 0.02). Smoking, drinking, and obesity were less common in this group, but results were not statistically significant.Conclusions: Patients with colorectal cancer have gotten progressively younger. The excess of colorectal cancer in AAs predominantly consists of more proximal, microsatellite stable tumors, commonly presenting lymphocytic infiltrate and less often associated with toxic exposures or a higher BMI. Younger AAs had more distal colorectal cancers than older ones. These data suggest two different mechanisms driving younger age and proximal location of colorectal cancers in AAs.",
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T1 - Excess of proximal microsatellite-stable colorectal cancer in african americans from a multiethnic study

AU - Xicola, Rosa M.

AU - Gagnon, Molly

AU - Clark, Julia R.

AU - Carroll, Timothy

AU - Gao, Weihua

AU - Fernandez, Christian

AU - Mijic, Dragana

AU - Rawson, James B.

AU - Janoski, Ashley

AU - Pusatcioglu, Cenk K.

AU - Rajaram, Priyanka

AU - Gluskin, Adam B.

AU - Regan, Maureen

AU - Chaudhry, Vivek

AU - Abcarian, Herand

AU - Blumetti, Jennifer

AU - Cintron, Jose

AU - Melson, Joshua

AU - Xie, Hui

AU - Guzman, Grace

AU - Emmadi, Rajyasree

AU - Alagiozian-Angelova, Victoria

AU - Kupfer, Sonia S.

AU - Braunschweig, Carol

AU - Ellis, Nathan

AU - Llor, Xavier

PY - 2014/9/15

Y1 - 2014/9/15

N2 - Purpose: African Americans (AA) have the highest incidence of colorectal cancer compared with other U.S. populations and more proximal colorectal cancers. The objective is to elucidate the basis of these cancer disparities.Experimental design: Of note, 566 AA and 328 non-Hispanic White (NHW) colorectal cancers were ascertained in five Chicago hospitals. Clinical and exposure data were collected. Microsatellite instability (MSI) and BRAF (V600E) and KRAS mutations were tested. Statistical significance of categorical variables was tested by the Fisher exact test or logistic regression and age by the Mann-Whitney U test.Results: Over a 10-year period, the median age at diagnosis significantly decreased for both AAs (68-61; P < 0.01) andNHWs(64.5- 62; P= 0.04); more AA patients were diagnosed before age 50 thanNHWs(22% vs. 15%; P = 0.01). AAs had more proximal colorectal cancer than NHWs (49.5% vs. 33.7%; P < 0.01), but overall frequencies of MSI, BRAF and KRAS mutations were not different nor were they different by location in the colon. Proximal colorectal cancers often presented with lymphocytic infiltrate (P < 0.01) and were diagnosed at older ages (P = 0.02). Smoking, drinking, and obesity were less common in this group, but results were not statistically significant.Conclusions: Patients with colorectal cancer have gotten progressively younger. The excess of colorectal cancer in AAs predominantly consists of more proximal, microsatellite stable tumors, commonly presenting lymphocytic infiltrate and less often associated with toxic exposures or a higher BMI. Younger AAs had more distal colorectal cancers than older ones. These data suggest two different mechanisms driving younger age and proximal location of colorectal cancers in AAs.

AB - Purpose: African Americans (AA) have the highest incidence of colorectal cancer compared with other U.S. populations and more proximal colorectal cancers. The objective is to elucidate the basis of these cancer disparities.Experimental design: Of note, 566 AA and 328 non-Hispanic White (NHW) colorectal cancers were ascertained in five Chicago hospitals. Clinical and exposure data were collected. Microsatellite instability (MSI) and BRAF (V600E) and KRAS mutations were tested. Statistical significance of categorical variables was tested by the Fisher exact test or logistic regression and age by the Mann-Whitney U test.Results: Over a 10-year period, the median age at diagnosis significantly decreased for both AAs (68-61; P < 0.01) andNHWs(64.5- 62; P= 0.04); more AA patients were diagnosed before age 50 thanNHWs(22% vs. 15%; P = 0.01). AAs had more proximal colorectal cancer than NHWs (49.5% vs. 33.7%; P < 0.01), but overall frequencies of MSI, BRAF and KRAS mutations were not different nor were they different by location in the colon. Proximal colorectal cancers often presented with lymphocytic infiltrate (P < 0.01) and were diagnosed at older ages (P = 0.02). Smoking, drinking, and obesity were less common in this group, but results were not statistically significant.Conclusions: Patients with colorectal cancer have gotten progressively younger. The excess of colorectal cancer in AAs predominantly consists of more proximal, microsatellite stable tumors, commonly presenting lymphocytic infiltrate and less often associated with toxic exposures or a higher BMI. Younger AAs had more distal colorectal cancers than older ones. These data suggest two different mechanisms driving younger age and proximal location of colorectal cancers in AAs.

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