Journal of Gastrointestinal & Digestive System
Open Access

Research Article

Patients Diagnosed with Colorectal Cancer in Rural Areas in Arizona Typically Present with Higher Stage Disease

Valentine N. Nfonsam^1*, Aparna Vijayasekaran¹, Viraj Pandit¹, Vera E¹, Hassan Aziz¹, Sumediah Nzuonkwelle¹, Eric Ohlson¹, Ryan M. DiGiovanni¹ and Jana Jandova^1,2

¹Department of Surgery, Division of Surgical Oncology, University of Arizona, Tucson, Arizona, USA

²Department of Pathology, University of Arizona, Tucson, Arizona, USA

*Corresponding Author:

Valentine N. Nfonsam
Division of Surgical Oncology
1501 N. Campbell Ave, #4334
Tucson, Arizona, 85724, USA
Tel: 520 626 7747
E-mail: vnfonsam@surgery.arizona.edu

Received date: July 27, 2015 Accepted date: September 28, 2015 Published date: October 06, 2015

Citation: Nfonsam VN, Vijayasekaran A, Pandit V, Vera E, Aziz H, et al. (2015) Patients Diagnosed with Colorectal Cancer in Rural Areas in Arizona Typically Present with Higher Stage Disease. J Gastrointest Dig Syst 5:346. doi:10.4172/2161-069X.1000346

Copyright: © 2015 Nfonsam VN, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Background: Despite the decreasing incidence of colorectal cancer (CRC) over the past three decades disparities remain in its incidence, stage at presentation, and efficiency of staging and treatment between different communities, particularly when comparing urban and rural areas. The aim of the study was to assess disparities that exist in CRC outcomes among urban, international border counties, and non-border counties in Arizona. Methods: A retrospective analysis of CRC data from the Arizona Cancer Registry was performed. Data obtained included age, sex, ethnicity, tumor grade, and tumor stage. The data was then categorized into three sections: international border counties, urban counties, and rural counties. The outcome measure was stage of CRC at diagnosis. Results: There were a total of 39, 958 reported incident cases of colorectal cancer from 1995-2010. Of the total incident cases, 53.1% were male and the average age at diagnosis was 69.5. 86.6% were white non-Hispanic, 8.37% Hispanic, 2.4% African American, 1.7% Native American and 1% Asian. There was a significant decrease in the incidence of CRC in all counties, 24.08% in border, 22.5% in urban, and 12.3% in rural. Rural counties showed a higher number of observed cases than expected cases of stage 4 CRC and more unknown diagnosis of grade, stage and lymph node assessment as determined by the adjusted residual. Conclusion: Patients in rural counties are more likely to present with a higher stage of CRC and are less likely to have their cancer adequately staged. This is likely due to lack of better access to healthcare, lack of awareness and poor education and also inadequate specialists.

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