Lower albumin levels in African Americans at colon cancer diagnosis: A potential explanation for outcome disparities between groups?

Aja S. McCutchen, Juan Carlos Munoz, Lacie Brenner, Peter Wludyka, Kenneth J Vega

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and aim Colorectal cancer is the third most common cancer and 3rd leading cause of cancer-related death in the USA. African Americans (AA) have inferior outcomes when matched for diagnosis stage and socioeconomic situation. Nutritional status, at diagnosis and its contribution to the observed cancer outcome disparity, between AA and non-Hispanic whites (nHw) has not been evaluated to date. The aim of the investigation was to determine if differences in nutritional surrogate markers, such as serum albumin and body mass index (BMI), exist at the time of colorectal cancer diagnosis between AA and nHw. Methods The University of Florida College of Medicine-Jacksonville endoscopy database was reviewed for all patients with a biopsied colorectal mass between January 2000 and December 2007. Patients were excluded if histology did not reveal colorectal adenocarcinoma or albumin/BMI was unavailable. Demographic data, tumor location, serum albumin within 60 days of diagnosis, presence of diabetes along with serum HbA1c were obtained. Results During the study period, 321 patients had colorectal masses discovered and 156 met entry criteria. There was no difference between ethnic groups regarding gender distribution, tumor location, diabetes presence, or BMI. Mean albumin was significantly less in AA compared to nHw (p<0.01). This persisted after adjustment for gender, presence/absence of diabetes, and BMI. Conclusions Lower albumin levels in AA indicate poorer nutritional status at colorectal cancer diagnosis compared to nHw. This may contribute to the outcome disparities observed between AA and nHw. Aggressive nutritional interventions to reverse this disparity should be evaluated.

Original languageEnglish (US)
Pages (from-to)469-472
Number of pages4
JournalInternational Journal of Colorectal Disease
Volume26
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

African Americans
Colonic Neoplasms
Albumins
Body Mass Index
Colorectal Neoplasms
Neoplasms
Nutritional Status
Serum Albumin
Ethnic Groups
Endoscopy
Histology
Adenocarcinoma
Biomarkers
Medicine
Demography
Databases
Serum

Keywords

  • Albumin
  • Colon cancer
  • Diagnosis
  • Disparities
  • Ethnicity

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Lower albumin levels in African Americans at colon cancer diagnosis : A potential explanation for outcome disparities between groups? / McCutchen, Aja S.; Munoz, Juan Carlos; Brenner, Lacie; Wludyka, Peter; Vega, Kenneth J.

In: International Journal of Colorectal Disease, Vol. 26, No. 4, 01.04.2011, p. 469-472.

Research output: Contribution to journalArticle

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N2 - Background and aim Colorectal cancer is the third most common cancer and 3rd leading cause of cancer-related death in the USA. African Americans (AA) have inferior outcomes when matched for diagnosis stage and socioeconomic situation. Nutritional status, at diagnosis and its contribution to the observed cancer outcome disparity, between AA and non-Hispanic whites (nHw) has not been evaluated to date. The aim of the investigation was to determine if differences in nutritional surrogate markers, such as serum albumin and body mass index (BMI), exist at the time of colorectal cancer diagnosis between AA and nHw. Methods The University of Florida College of Medicine-Jacksonville endoscopy database was reviewed for all patients with a biopsied colorectal mass between January 2000 and December 2007. Patients were excluded if histology did not reveal colorectal adenocarcinoma or albumin/BMI was unavailable. Demographic data, tumor location, serum albumin within 60 days of diagnosis, presence of diabetes along with serum HbA1c were obtained. Results During the study period, 321 patients had colorectal masses discovered and 156 met entry criteria. There was no difference between ethnic groups regarding gender distribution, tumor location, diabetes presence, or BMI. Mean albumin was significantly less in AA compared to nHw (p<0.01). This persisted after adjustment for gender, presence/absence of diabetes, and BMI. Conclusions Lower albumin levels in AA indicate poorer nutritional status at colorectal cancer diagnosis compared to nHw. This may contribute to the outcome disparities observed between AA and nHw. Aggressive nutritional interventions to reverse this disparity should be evaluated.

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