Racial and ethnic disparities in colorectal cancer incidence and mortality

• Published in: Advances in cancer research Vol. 151; pp. 197 - 229
• Main Author: Carethers, John M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2021
• Subjects: African American; African Americans - statistics & numerical data; Colon cancer disparity; Colon cancer genetics; Colon cancer risk; Colon cancer screening; Colon cancer survival; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - ethnology; Colorectal Neoplasms - mortality; Ethnicity; Ethnicity - statistics & numerical data; Family history; Health Status Disparities; Healthcare Disparities - ethnology; Healthcare Disparities - statistics & numerical data; Humans; Incidence; Inherited colon cancer syndrome; Mortality - ethnology; Race; Racial Groups - ethnology; Racial Groups - statistics & numerical data; United States - epidemiology; United States; Colon cancer genetics; Ethnicity; Colon cancer survival; Colon cancer risk; Race; Inherited colon cancer syndrome; Family history; Colon cancer disparity; Colon cancer screening; African American
• ISSN: 0065-230X; 2162-5557; 2162-5557
• DOI: 10.1016/bs.acr.2021.02.007

The occurrence of colorectal cancer (CRC) shows a large disparity among recognized races and ethnicities in the U.S., with Black Americans demonstrating the highest incidence and mortality from this disease. Contributors for the observed CRC disparity appear to be multifactorial and consequential that may be initiated by structured societal issues (e.g., low socioeconomic status and lack of adequate health insurance) that facilitate abnormal environmental factors (through use of tobacco and alcohol, and poor diet composition that modifies one's metabolism, microbiome and local immune microenvironment) and trigger cancer-specific immune and genetic changes (e.g., localized inflammation and somatic driver gene mutations). Mitigating the disparity by prevention through CRC screening has been demonstrated; this has not been adequately shown once CRC has developed. Acquiring additional knowledge into the science behind the observed disparity will inform approaches towards abating both the incidence and mortality of CRC between U.S. racial and ethnic groups.