Colorectal carcinoma--a new threat to black patients? A retrospective analysis of colorectal carcinoma received by the Institute for Pathology, University of Pretoria.

OBJECTIVE: To compare black and white patients with colorectal carcinoma treated at Pretoria Academic and Kalafong hospitals, and to compare pathological trends of our study population with others reported in the literature.
DESIGN: A retrospective study of all cases of resected colorectal carcinomas received by our department during the periods 1986-1987 (82 cases) and 1996-1997 (91 cases). To investigate variables of age, race and gender distribution in the two study populations.
METHODS: Routinely stained histological sections of all relevant cases were examined. Findings regarding age, gender, population group, anatomical location of the tumour and presence of other pathological lesions were recorded. Changes in the referral population and number of surgical specimens received were also considered during statistical analysis of the study findings.
RESULTS: There has been a significant increase in the number of black patients with colorectal carcinoma at our Institute. In addition, adenomatous polyps were found in 9 of our black patients (1996/97). This is significantly higher than expected from reports in the literature. This could be predictive of an increase in incidence of colorectal carcinomas in our black population. Black patients were also found to be considerably younger at age of presentation than their white counterparts. A further significant finding was a considerable increase in the number of black females under the age of 40 years from 1986/87 to 1996/97. On the other hand, the number of white females above 40 years of age decreased considerably over this time. The reason for this finding is uncertain and warrants further study.