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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Gastroenterology

Abstract

Colorectal cancer (CRC) continues to be a public health burden and is the second leading cause of American cancer deaths. Strides have been made in the medical community, and there has been an overall decrease in CRC rates. This decrease is primarily due to a cumulative decline in late-onset colorectal cancer diagnosis (LOCRC), defined as CRC cancer in adults over the age of 50 years. CRC continues to burden American Indians and Alaska Natives (AIAN) and Non-Hispanic Black individuals (NHB) disproportionately. The incidence and mortality rates remain disproportionately higher than other ethnic groups, and the survival rate is lower than other ethnicities. Although the CRC incidence and mortality rates of AN have historically been higher than Non-Hispanic White individuals (NHW), NHB individuals were on par with this group in the past. The steep increase in CRC diagnoses started only in the 1980s and has remained elevated for decades. Furthermore, the decreasing CRC rates only account for one subset of CRC, late-onset colorectal cancer (LOCRC). Early onset colorectal cancer (EOCRC) is defined as adults under the age of 50 years, and their rates have steadily increased since 2012. AIAN and NHB are heavily affected by EOCRC as well. Although several measures have been implemented to address these disparities in recent years, rates continue to be elevated. This is despite additional CRC screening methods and screening recommendations at younger ages. AIAN and NHB continue to suffer disproportionately with increased occurrences and poor outcomes. Recent studies hypothesize several potential explanations, including risk factors, modifiable risk factors, socioeconomic status, and differences in CRC screening and treatment; however, continued studies must be conducted to further assist patients, families, and providers in prevention and early detection.

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