Published in Cancer Detection and Prevention 2001; 25(5):430-438.

Predictors of Advanced Stage Colorectal Cancer Diagnosis: Results of a Population-Based Study

Robert J. Campbell, MD,a Jeanne M. Ferrante, MD,a,b Eduardo C. Gonzalez, MD,a Richard G. Roetzheim, MD, MSPH,a,b Naazneen Pal, MPH,a and Arthur Herold, MDa

aDepartment of Family Medicine and bDivision of Cancer Control, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL

Address all correspondence and reprints to Robert Campbell, MD, University of South Florida Department of Family Medicine. 12901 Bruce B. Downs Blvd. MDC 13. Tampa, FL 33612.

ABSTRACT: While colon cancer is a leading cause of morbidity and mortality among men and women, little is known about demographic variables associated with advanced stage diagnosis at diagnosis. We examined the relationship of age, gender, income, education, marital status, smoking status, urban versus rural residence, and proximal versus distal tumor location on stage at diagnosis. Data from Florida statewide cancer registry for the year 1994 with over 8,933 cases of colorectal cancer was analyzed. Using multivariate analysis, an odds ratio of being diagnosed with advanced stage disease was determined for each demographic variable. We found a significantly increased probability (P < .05) of diagnosis with advanced stage disease for distal lesions only in middle-aged persons, smokers, and those with higher education or lower income status. If these findings are verified, they may suggest a group that warrants targeted screening intervention or programs over and above today's current colorectal screening recommendations.

KEY WORDS: colon cancer, demographics, stage at diagnosis.