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Understanding racial differences in colorectal cancer aids in individualized medicine.

Colorectal cancer (CRC) is the third most common cancer in both men and women. It affects all racial and ethnic groups, and is commonly found in people aged 50 years or older. Most deaths result from the effects of persistent disease. In the USA, there are racial differences, more specifically, African–Americans have the highest incidence and mortality rates among all ethnic groups in the USA [1]. Furthermore, incidence and mortality rates among Caucasians have been steadily declining, whereas rates among African–Americans have only started a gradual decline in recent years [1]. Race is defined as a continuously evolving social construct used to categorize individuals into groups that have typically been based on physical characteristics (e.g., skin color, hair texture or other distinctive characteristics) of an individual or his/her ancestors. Ethnicity refers to cultural groups that have typically been defined by a common language, religion, nationality or heritage. Socioeconomic differences, increased exposure and susceptibility to dietary carcinogens and potentially harmful substances, such as tobacco smoke and alcohol, variability in clinicopathological characteristics, and inadequate detection and medical care are the primary factors that have been hypothesized to contribute to racial/ethnic disparity in clinical outcomes of CRC [2–8].