Minimonograph Colon Cancer Powerpoint

CANCER IN LOS ANGELES COUNTY:
Colon Cancer 2000-2017
Los Angeles Cancer Surveillance Program

USC/Norris Comprehensive Cancer Center
The Keck School of Medicine of the University of Southern
California
1
CANCER IN LOS ANGELES COUNTY:
Colon Cancer 2000-2017
Amie Eunah Hwang, PhD

Kai-Ya Tsai, MSPH
James Huynh
Lihua Liu, PhD
Heinz-Josef Lenz, MD
Dennis Deapen, DrPH
2020
Los Angeles Cancer Surveillance Program

USC/Norris Comprehensive Cancer Center
The Keck School of Medicine of the University of Southern California
Suggested Citation:
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D. Cancer in Los Angeles County: Colon Cancer 2000-2017. Los Angeles
Cancer Surveillance Program, Norris Comprehensive Cancer Center, University of Southern California, 2020.
Copyright© 2020 by the University of Southern California.

All rights reserved.
This document, or parts thereof, may be reproduced in any form with citation.
2
COLON CANCER STATISTICS BY PATIENT AND TUMOR CHARACTERISTICS
Table 1. Frequency of Invasive Colon Cancer Cases by Age, Race, Socioeconomic Status and Disease Stage,
Los Angeles County, 2000-2017.
Male Female Male and Female
N % N % N %
Age (years)
0-39 633 3 622 3 1,255 3
40-49 1,627 7 1,596 6 3,223 7
50-64 6,935 29 6,139 25 13,074 27
65+ 15,083 62 16,498 66 31,581 64
Race/Ethnicity
Non-Hispanic White 11,848 49 11,866 48 23,714 48
Non-Hispanic Black 3,023 12 3,506 14 6,529 13
Hispanic 5,571 23 5,561 22 11,132 23
Asian/Pacific Islander 3,641 15 3,761 15 7,402 15
Other/Missing 195 1 161 1 356 1
Asian/Pacific Islander Ethnicity
Chinese 1,131 5 1,079 4 2,210 4
Japanese 582 2 653 3 1,235 3
Filipino 677 3 800 3 1,477 3
Korean 624 3 556 2 1,180 2
Vietnamese 230 1 251 1 481 1
South Asian 106 <1 77 <1 183 <1
Thai/Hmong/Cambodian/Laotian 130 1 144 1 274 1
Hawaiian/Samoan 49 <1 64 <1 113 <1
Socioeconomic Status
High 4,907 20 4,821 19 9,728 20
Mid-High 5,097 21 5,342 21 10,439 21
Middle 4,632 19 5,012 20 9,644 20
Mid-Low 5,163 21 5,057 20 10,220 21
Low 4,479 18 4,623 19 9,102 19
Disease Stage
Localized 9,032 37 8,924 36 17,956 37
Regional 8,779 36 9,110 37 17,889 36
Distant 5,031 21 5,164 21 10,195 21
Suggested Citation: Unknown 1,436 6 1,657 7 3,093 6
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D. Cancer
in Los Angeles County: Colon Cancer 2000-2017. Los Angeles
Cancer Surveillance Program, Norris Comprehensive Cancer
Center, University of Southern California, 2020.
3
Figure 1A. Disease Stage Distribution of Invasive Colon Cancer by Age,

45%
40%
35%
Proportion of cases 30%
25%
20%
15%
10%
5%
0%
Age 0-39 Age 40-49 Age 50-64 Age 65+
Localized Regional Distant
Suggested Citation:
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D. Cancer in Los Angeles County: Colon Cancer 2000-2017. Los 4
Angeles Cancer Surveillance Program, Norris Comprehensive Cancer Center, University of Southern California, 2020.
.
Figure 1B. Disease Stage Distribution of Invasive Colon Cancer by Race/Ethnicity,
50%
45%
40%
35%
30%
25%
20%
Proportion of cases
15%
10%
5%
0%
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Suggested Citation:
Figure 1C. Disease Stage Distribution of Invasive Colon Cancer by Socioeconomic Status,
45%
40%
35%
30%
Proportion of cases
25%
20%
15%
10%
5%
0%
Highest Upper-Middle Middle Lower-Middle Lowest
Suggested Citation:
Table 2A. Age-Adjusted Incidence Rates of Invasive Colon Cancer by Sex, Age, Race/Ethnicity and Disease Stage (per 100,000 population),
Male and
Male Female Female
Total 34.0 26.9 30.0
Age (years)
0-39 1.2 1.2 1.2
40-49 12.7 12.3 12.5
50-64 49.9 40.6 45.0
65+ 188.6 144.2 163.1
Race/Ethnicity
Non-Hispanic White 36.2 28.9 32.2
Non-Hispanic Black 47.3 38.9 42.4
Hispanic 26.9 20.5 23.2
Asian/Pacific Islander 30.8 24.1 27.0
Chinese 28.9 22.5 25.4
Japanese 39.4 31.5 34.8
Filipino 27.0 20.8 23.1
Korean 34.6 22.5 27.5
Vietnamese 31.9 29.4 30.4
South Asian 16.4 11.9 14.1
Thai/Hmong/Cambodian/Laotian 31.6 25.7 27.8
Hawaiian/Samoan 54.1 49.9 49.9
Suggested Citation: Disease Stage
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D.
Cancer in Los Angeles County: Colon Cancer 2000-2017. Localized 12.7 9.7 11.0
Los Angeles Cancer Surveillance Program, Norris Regional 12.3 9.9 10.9
Comprehensive Cancer Center, University of Southern
California, 2020. Distant 6.8 5.6 6.1 7
Table 2B. Incidence Rate Ratio for Invasive Colon Cancer by Sex and Race/Ethnicity,
Male and
Male Female
Female
Race/Ethnicity
Non-Hispanic White (Reference) 1.00 1.00 1.00
Hispanic 0.74 0.71 0.72
Chinese 0.80 0.78 0.79
Japanese 1.09 1.09 1.08
Filipino 0.75 0.72 0.72
Korean 0.96 0.78 0.85
South Asian 0.45 0.41 0.44
Hawaiian/Samoan 1.50 1.72 1.55
Suggested Citation:
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D. Cancer in Los Angeles County: Colon Cancer 2000-
2017. Los Angeles Cancer Surveillance Program, Norris Comprehensive Cancer Center, University of Southern 8
California, 2020.
Figure 2A. Annual Incidence Rate Trends of Invasive Colon Cancer by Disease Stage (per
100,000),
16.0
14.0
12.0
Age-Adjusted Incidence Rate
10.0
8.0
6.0
4.0
2.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Diagnosis
Suggested Citation:
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen D. Cancer in Los Angeles County: Colon Cancer 2000-2017. Los
9
Figure 2B. Annual Incidence Rate Trends of Invasive Colon Cancer by Race/Ethnicity among Males (per 100,000),
70.0
60.0
50.0

40.0
30.0
20.0
10.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Diagnosis
Non-Hispanic White Non-Hispanic Black Hispanic Asian Pacific Islander
Suggested Citation:
10
Figure 2C. Annual Incidence Rate Trends of Invasive Colon Cancer by Race/Ethnicity among Females (per 100,000),
60.0
50.0
40.0
30.0
20.0
10.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Diagnosis
Suggested Citation:
11
Table 3A. Age-Adjusted Mortality Rates of Colon Cancer by Sex, Age, and Race/Ethnicity (per 100,000 population),
Male and
Male Female
Female
Total 14.8 11.0 12.6
Age (years)
0-39 0.4 0.3 0.3
40-49 4.5 3.9 4.
50-64 17.7 13.2 15.4
65+ 89.1 64.8 74.9
Race/Ethnicity
Non-Hispanic White 14.8 11.4 12.9
Hispanic 12.8 8.7 10.4
Chinese 13.6 9.6 11.4
Japanese 17.2 11.6 14.0
Filipino 11.7 7.0 8.8
Korean 13.4 9.1 10.8
Suggested Citation: Vietnamese 10.3 5.8 7.8

Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen
South Asian 4.3 4.5 4.5
D. Cancer in Los Angeles County: Colon Cancer 2000-
2017. Los Angeles Cancer Surveillance Program, Norris Thai/Hmong/Cambodian/Laotian 17.2 8.7 11.5
Comprehensive Cancer Center, University of Southern
California, 2020. Hawaiian/Samoan 12.0 9.4 10.7 12
Table 3B. Mortality Rate Ratios for Colon Cancer by Sex and Race/Ethnicity,
Male and
Male Female
Female
Race/Ethnicity
Hispanic 0.87 0.76 0.80
Chinese 0.92 0.84 0.88
Japanese 1.16 1.01 1.08
Filipino 0.79 0.62 0.68
Korean 0.90 0.79 0.84
Suggested Citation: South Asian 0.29 0.40 0.35

Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J,
Deapen D. Cancer in Los Angeles County: Colon
Cancer 2000-2017. Los Angeles Cancer Surveillance
Program, Norris Comprehensive Cancer Center,
University of Southern California, 2020. Hawaiian/Samoan 0.81 0.82 0.82
13
Figure 3A. Annual Mortality Rate Trends of Colon Cancer by Age (per 100,000),
Los Angeles County, 2000- 2017 .
100.0
90.0
80.0
70.0
Age-Adjusted Mortality Rate
5
60.0
50.0
40.0
30.0
20.0
10.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Death
Age 0 to 39 Age 40 to 49 Age 50 to 64 Age 65+
Suggested Citation:
14
Figure 3B. Annual Mortality Rate Trends of Colon Cancer by Race/Ethnicity among Males (per
100,000), Los Angeles County, 2000- 2017 .
40.0
35.0
Age-Adjusted Mortality Rate 30.0
25.0
20.0
15.0
10.0
5.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Death
Non-Hispanic White Non Hispanic Black Hispanic Asian Pacific Islander
Suggested Citation:
15
Figure 3C. Annual Mortality Rate Trends of Colon Cancer by Race/Ethnicity among Females (per 100,000),
Los Angeles County, 2000- 2017.
30.0
25.0
Age-Adjusted Mortality Rate 20.0
15.0
10.0
5.0
0.0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Year of Death
Non Hispanic White Non Hispanic Black Hispanic Asian Pacific Islander
Suggested Citation:
16
Table 4. One- and Five-year Observed Survival from Invasive Colon Cancer by Sex, Age, Race/Ethnicity, Socioeconomic Status and Disease
Stage, Los Angeles County, 2000-2017.
1 Year 5 Year
95% CI 95% CI
Survival (%) Survival (%)
Sex
Males 76.3 75.8-76.9 49.1 48.4-49.7
Females 75.6 75.1-76.2 49.4 48.7-50.1
Age (years)
0-39 86.8 84.7-88.7 59.1 55.8-62.1
40-49 85.7 84.4-86.9 61.5 59.6-63.3
50-64 84.6 83.9-85.2 61.0 60.1-61.9
65+ 71.0 70.5-71.5 42.9 42.4-43.5
Race/Ethnicity
Non-Hispanic White 74.8 74.3-75.4 47.7 47.0-48.4
Non-Hispanic Black 71.5 70.4-72.6 43.9 42.6-45.2
Hispanic 78.3 77.5-79.1 52.2 51.2-53.3
Asian/Pacific Islander 79.6 78.6-80.5 53.7 52.4-54.9
Chinese 79.6 77.8-81.2 54.8 52.5-57.0
Japanese 76.5 74.0-78.8 50.6 47.6-53.5
Filipino 80.8 78.6-82.7 53.9 51.0-56.6
Korean 81.7 79.3-83.8 55.7 52.5-58.7
Vietnamese 81.4 77.5-84.6 49.5 44.5-54.4
South Asian 83.8 77.4-88.5 60.6 52.4-67.9
75.7 48.0
Thai/Hmong/Cambodian/Laotian 70.0-80.4 41.3-54.5
Hawaiian/Samoan 71.9 62.5-79.3 49.5 39.4-58.8
High 79.8 78.9-80.6 53.4 52.4-54.5
Mid-High 77.8 77.0-78.6 50.9 49.8-51.9
Middle 75.9 75.0-76.8 49.2 48.1-50.3
Mid-Low 75.2 74.3-76.1 48.0 46.9-49.0
Low 73.6 72.6-74.5 46.0 44.8-47.1
Disease Stage
Suggested Citation: Localized 90.6 90.2-91.1 71.6 70.9-72.3
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen Regional 84.0 83.4-84.5 54.4 53.6-55.2
D. Cancer in Los Angeles County: Colon Cancer Distant 45.0 44.0-45.9 10.0 9.4-10.7
2000-2017. Los Angeles Cancer Surveillance Unknown 43.1 41.1-45.0 15.3 13.8-16.8
Program, Norris Comprehensive Cancer Center,
University of Southern California, 2020.
17
CI: Confidence Interval
Table 5. One- and Five-year Relative* Survival from Invasive Colon Cancer by Age, Race/Ethnicity, Socioeconomic Status and Disease Stage,
1 Year Survival 5 Year
95% CI 95% CI
(%) Survival (%)
Sex
Males 82.0 81.4-82.6 63.7 62.8-64.6
Females 80.5 79.9-81.1 62.2 61.3-63.1
Age (years)
0-39 89.3 87.3 - 91.0 62.3 58.9 - 65.5
40-49 87.5 86.2 - 88.7 64.2 62.2 - 66.2
50-64 87.1 86.4 - 87.7 66.7 65.7 - 67.7
65+ 77.2 76.6 - 77.8 61.0 60.1 - 61.9
Race/Ethnicity
Non-Hispanic White 80.8 80.2 - 81.5 64.4 63.4 - 65.4
Non-Hispanic Black 76.9 75.6 - 78.1 56.1 54.4 - 57.8
Hispanic 82.5 81.7 - 83.3 62.6 61.4 - 63.9
Asian/Pacific Islander 83.8 82.8 - 84.8 63.4 61.9 - 64.8
Chinese 84.3 82.4 - 86.0 66.4 63.6 - 69.0
Japanese 80.0 77.2 - 82.6 60.4 56.5 - 64.1
Filipino 85.5 83.3 - 87.5 63.0 59.6 - 66.2
Korean 85.5 82.9 - 87.7 65.2 61.4 - 68.7
Vietnamese 85.4 81.3 - 88.6 57.5 51.6 - 62.9
South Asian 88.6 81.5 - 93.2 65.7 55.5 - 74.2
Thai/Hmong/Cambodian/Laotian 77.3 71.1 - 82.3 51.2 43.6 - 58.4
Hawaiian/Samoan 74.3 63.8 - 82.1 58.4 45.9 - 69.0
High 85.5 84.6 - 86.4 70.1 68.6 - 71.6
Mid-High 82.5 81.6 - 83.4 65.5 64.1 - 66.9
Middle 80.4 79.4 - 81.3 61.8 60.3 - 63.2
Mid-Low 80.0 79.0 - 80.9 60.2 58.9 - 61.6
Low 78.1 77.0 - 79.1 57.0 55.6 - 58.4
Disease Stage
Localized 95.9 95.5 - 96.4 91.8 90.9 - 92.7
Regional 89.7 89.2 - 90.3 70.0 68.9 - 71.0
Suggested Citation: 50.6 49.5 - 51.7 13.1 12.2 - 13.9
Distant
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen 48.9 46.5 - 51.3 22.7 20.4 - 25.1
Unknown
D. Cancer in Los Angeles County: Colon Cancer
2000-2017. Los Angeles Cancer Surveillance *Relative survival estimates the probability of survival from cancer considering the chances of
Program, Norris Comprehensive Cancer Center, dying from other causes. It is calculated as a ratio of the observed survival among cancer patients
to the expected survival from all causes of death.
18
Figure 4A. Annual 5-year Observed Survival Trends of Colon Cancer by Race/Ethnicity among Males,
65.0%
60.0%
55.0%
5-year Survival Probabilities
50.0%
45.0%
40.0%
35.0%
30.0%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Yea of Diagnosis
Suggested Citation:
19
Figure 4B. Annual 5-year Observed Survival Trends of Colon Cancer by Race/Ethnicity among Females,
65.0%
60.0%
55.0%
5-year Survival Probabilities
50.0%
45.0%
40.0%
35.0%
30.0%
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
Year of Diagnosis
Suggested Citation:
20
Figure 5A. Kaplan-Meier Observed Survival Curves for Invasive Colon

Cancer by Age, Los Angeles County, 2000-2017.
1.0
0.8
0.6
0.4
0.2
0-39
40-49
50-64
0.0 65+
0 50 100 150 200
Months
Suggested Citation:
21
Figure 5B. Kaplan-Meier Survival Curves for Invasive Colon Cancer by Race/Ethnicity
among Males, Los Angeles County, 2000-2017.
1.0
0.8
0.6
0.4
0.2
0.0
0 50 100 150 200
Months
Suggested Citation:
22
Figure 5C. Kaplan-Meier Survival Curves for Invasive Colon Cancer by Race/Ethnicity
among Females, Los Angeles County, 2000-2017.
Suggested Citation:
23
Table 6. Hazard Ratio* of Invasive Colon Cancer by Age, Race/Ethnicity, Socioeconomic Status and Disease Stage,
Male Female Male and Female
HR 95% CI HR 95% CI HR 95% CI
Sex
Males (Reference) 1.00
Females 0.94 0.92 - 0.96
Age
0-39 (Reference) 1.00 1.00 1.00
40-49 0.99 0.85 - 1.15 1.09 0.93 - 1.27 1.04 0.93 - 1.15
50-64 1.21 1.06 - 1.38 1.28 1.11 - 1.47 1.24 1.13 - 1.37
65+ 2.54 2.24 - 2.88 3.08 2.69 - 3.53 2.79 2.55 - 3.07
Race/Ethnicity
Non-Hispanic Black 1.05 1 - 1.11 0.98 0.94 - 1.03 1.02 0.98 - 1.05
Hispanic 0.87 0.83 - 0.91 0.83 0.79 - 0.87 0.85 0.82 - 0.88
Asian Pacific Islander 0.82 0.78 - 0.86 0.75 0.72 - 0.79 0.79 0.76 - 0.81
High (Reference) 1.00 1.00 1.00
Mid-High 1.07 1.02 - 1.13 1.11 1.05 - 1.17 1.09 1.05 - 1.13
Middle 1.15 1.09 - 1.22 1.16 1.1 - 1.23 1.16 1.12 - 1.21
Mid-Low 1.22 1.16 - 1.29 1.25 1.19 - 1.32 1.24 1.19 - 1.29
Low 1.33 1.25 - 1.4 1.27 1.2 - 1.35 1.30 1.25 - 1.35
Suggested Citation:
Disease Stage
Hwang AE, Tsai KY, Huynh J, Liu L, Lenz H-J, Deapen Localized (Reference) 1.00 1.00 1.00
D. Cancer in Los Angeles County: Colon Cancer Regional 1.54 1.47 - 1.6 1.60 1.53 - 1.67 1.57 1.52 - 1.61
2000-2017. Los Angeles Cancer Surveillance
Program, Norris Comprehensive Cancer Center, Distant 6.52 6.23 - 6.82 6.78 6.47 - 7.09 6.62 6.41 - 6.84
Unknown 4.92 4.59 - 5.27 5.40 5.05 - 5.77 5.17 4.93 - 5.43
24
*Hazard ratios (HR) obtained from multivariate Cox regression models adjusting for all variables listed.
SUMMARY OF COLON CANCER RISK FACTORS
Modifiable Risk Factors
EXCESS WEIGHT
Excess weight is a known risk factor for colon cancer. Individuals with a higher body mass index (BMI), especially men, are at an increased risk. Every
5kg/m2 increase in BMI is associated with an additional 20% increase in risk. 1 It is estimated that a quarter of the population in Los Angeles and nearly
40% of all adults in the US are obese.2
SEDENTARY BEHAVIORS
Physical inactivity throughout the day leads to a greater chance of developing colon cancer, independent of obesity. Working in a sedentary occupation,
such as an office job where most of the day is spent sitting, more than doubles the risk of colon cancer. 3-4
RED MEAT AND PROCESSED MEATS
The International Agency for Research on Cancer classifies processed meat as carcinogenic to humans and red meat as possibly carcinogenic. They
concluded there was a strong positive association observed between the consumption of red meat or processed meat and Colon cancer. Eating red meat
and processed meat on a regular basis may increase the risk of colorectal cancer by 17-18%. 5 Los Angeles ranked #1 in hot dog and sausage consumption
in the US, consuming 31 million pounds in 2018. In the same year, 2.6 million Dodger dogs were consumed by Los Angeles County baseball fans. 6
SMOKING
Smoking is a known cause of multiple cancers. Long-term smoking increases the risk of colon cancer by 20-40%. 7 One-fifth of Black, Hispanic, and Asian
males in Los Angeles are current smokers.2
ALCOHOL
Alcohol intake raises the risk of colon cancer. The risk increases with the amount of alcohol consumed for men and women. Heavy drinkers were found
to be have a 45% greater likelihood of developing colon cancer than non-drinkers. 8 16% of adults in Los Angeles reported binge drinking (5 or more
drinks for men, 4 or more for women), in the past month. 2
25
Non-modifiable Risk Factors
FAMILY HISTORY AND INHERITED DISEASES

Those with a family history of colon cancer in a first-degree relative have 2-3 fold risk. 9 Inherited diseases, such as familial adenomatous
polyposis (FAP) and certain genetic mutations lead to predisposition to colon cancer. If left untreated, nearly everyone with FAP will
eventually develop cancer of the colon or the rectum within their lifetime. 10
INFLAMMATORY BOWEL DISEASE (IBD)

IBD, such as Crohn’s disease or ulcerative colitis, elevates the risk for colon cancer. 1.3% of adults in the US have IBD. 11 Studies from around the world
concluded that those with IBD were 2-3 times as likely to develop colon cancer. 12
RACE AND ETHNICITY
Non-Hispanic Blacks and Ashkenazi Jews have higher risks of colon cancer compared to Non-Hispanic Whites. 13-14 The population of Los Angeles County is
comprised of nearly 10% Non-Hispanic Blacks and has the second largest Jewish population in the United States. 15-16
26
REFERENCES
1. Renehan, Andrew G., et al. "Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies." The Lancet
371.9612 (2008): 569-578.
2. Los Angeles County Department of Public Health, Office of Health Assessment and Epidemiology. Key Indicators of Health by Service Planning Area (2017).
3. Lynch, Brigid M. "Sedentary behavior and cancer: a systematic review of the literature and proposed biological mechanisms." Cancer Epidemiology and Prevention
Biomarkers 19.11 (2010): 2691-2709.
4. Boyle, Terry, et al. "Long-term sedentary work and the risk of subsite-specific colorectal cancer." American Journal of Epidemiology 173.10 (2011): 1183-1191.
5. Bouvard, Véronique, et al. "Carcinogenicity of consumption of red and processed meat." The Lancet Oncology 16.16 (2015): 1599-1600.
6. The National Hot and Sausage Council. “Consumption Statistics from the National Hot Dog and Sausage Council.” Consumption Stats, NHDSC www.hot-
dog.org/media/consumption-stats. Accessed 29 November 2019
7. Coyle, Yvonne M. "Lifestyle, genes, and cancer." Cancer Epidemiology 472.1 (2009): 25-56.
8. Cho E, Smith-Warner SA, Ritz J, et al. "Alcohol intake and colorectal cancer: a pooled analysis of 8 cohort studies." Annals of Internal Medicine. 140.1 (2004): 603–
13.
9. Calvert, Paula M. and Harold Frucht. "The genetics of colorectal cancer." Annals of Internal Medicine 137.7 (2002): 603-612.
10. Sampson, Julian R., et al. "Autosomal recessive colorectal adenomatous polyposis due to inherited mutations of MYH." The Lancet 362.9377 (2003): 39-41.
11. Dahlhamer, James M., et al. "Prevalence of inflammatory bowel disease among adults aged≥ 18 years—United States, 2015." Morbidity and Mortality Weekly
Report 65.42 (2016): 1166-1169.
12. Xie, Jianlin and Itzkowitz, Steven H. "Cancer in inflammatory bowel disease." World Journal of Gastroenterology 14.3 (2008): 378.
13. Ollberding, Nicholas J., et al. "Racial/ethnic differences in colorectal cancer risk: the multiethnic cohort study." International Journal of Cancer 129.8 (2011): 1899-
1906.
14. Boursi, Ben, et al. "The APC p. I1307K polymorphism is a significant risk factor for CRC in average risk Ashkenazi Jews." European Journal of Cancer 49.17 (2013):
3680- 3685.
15. Tighe, Elizabeth, et al. “Summary& Highlights- 2019”. The American Jewish Population Project (2019): 04-05
16. U.S. Census Bureau. American Community Survey, 2018 American Community Survey 5-Year Estimates, Table B02001. U.S. Census website. Retrieved May 02, 2020
27

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CANCER IN LOS ANGELES COUNTY:

Colon Cancer 2000-2017

Los Angeles Cancer Surveillance Program

Amie Eunah Hwang, PhD

Los Angeles Cancer Surveillance Program

Copyright© 2020 by the University of Southern California.

Figure 1A. Disease Stage Distribution of Invasive Colon Cancer by Age,

Proportion of cases 30%

Localized Regional Distant

Localized Regional Distant

Age-Adjusted Incidence Rate

Non-Hispanic White Non-Hispanic Black Hispanic Asian Pacific Islander

Non-Hispanic White Non-Hispanic Black Hispanic Asian Pacific Islander

Suggested Citation: Vietnamese 10.3 5.8 7.8

Non-Hispanic White (Reference) 1.00 1.00 1.00

Non-Hispanic Black 1.60 1.56 1.56

Hispanic 0.87 0.76 0.80

Asian/Pacific Islander 0.88 0.78 0.82

Asian/Pacific Islander Ethnicity

Chinese 0.92 0.84 0.88

Japanese 1.16 1.01 1.08

Filipino 0.79 0.62 0.68

Korean 0.90 0.79 0.84

Vietnamese 0.69 0.50 0.60

Suggested Citation: South Asian 0.29 0.40 0.35

Age 0 to 39 Age 40 to 49 Age 50 to 64 Age 65+

Age-Adjusted Mortality Rate 30.0

Non-Hispanic White Non Hispanic Black Hispanic Asian Pacific Islander

Age-Adjusted Mortality Rate 20.0

Non-Hispanic White Non-Hispanic Black Hispanic Asian Pacific Islander

Non-Hispanic White Non-Hispanic Black Hispanic Asian Pacific Islander

Figure 5A. Kaplan-Meier Observed Survival Curves for Invasive Colon

Modifiable Risk Factors

RED MEAT AND PROCESSED MEATS

Non-modifiable Risk Factors

FAMILY HISTORY AND INHERITED DISEASES

INFLAMMATORY BOWEL DISEASE (IBD)

RACE AND ETHNICITY

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