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Purpose: Colorectal cancer (CRC) incidence has decreased over the past three decades, due largely to screening efforts. Relatively little is known about CRC incidence among the young adult (YA) population ages 20-39, as screening typically commences at age 50 for average-risk individuals. We examined CRC incidence with a focus on YAs in order to identify high-risk subgroups. Methods: We analyzed 231,544 incident CRC cases from 1988-2009 (including 5617 YAs 20-39 years of age) from the California Cancer Registry. We assessed age-specific incidence rates by race/ethnicity, gender, and colorectal tumor location, and calculated the biannual percent change (BAPC) to monitor change in incidence over the 22-year study period. Results: The absolute incidence of CRC per 100,000 was low among YAs 20-29 and 30-39 years old (ranging from 0.7 per 100,000 among Hispanic and African American females aged 20-29 up to 5.0 per 100,000 among Asian/Pacific Islander males aged 30-39). However, we observed increasing CRC incidence rates over time among both males and females in the YA population, particularly for distal colon cancer in Hispanic females aged 20-29 (BAPC=+15.9%; p<0.042). Conclusion: The absolute incidence of CRC remains far lower for YAs than among adults aged 50 and over. However, CRC incidence is increasing among young adults, in contrast to the decreasing rates observed for adults in the screened population (aged 50 and above). More research is needed to better characterize YAs at increased risk for CRC. [ABSTRACT FROM AUTHOR]

Background: Lymph node retrieval is an independent prognostic factor for survival in rectal cancer. Preoperative radiotherapy has been shown to impact the number of lymph nodes retrieved., Objective: This study aimed to analyze colorectal cancer-specific mortality and overall mortality associated with the number of lymph nodes retrieved in relation to use and timing of radiotherapy., Design: This study was designed as a retrospective analysis., Settings: Analysis of the California Cancer Registry was conducted., Patients: Patients with rectal cancer from 1994 to 2006 with a follow-up until January 2008 were included., Main Outcome Measures: The number of lymph nodes (1-3, 4-6, 7-11, ≥ 12) stratified by stage (I, II, and III) was analyzed based on radiotherapy status (no radiotherapy, preoperative radiotherapy, and postoperative radiotherapy). Multivariate colorectal cancer-specific survival and overall mortality analyses were performed using Cox proportional-hazard ratios., Results: A total of 17,670 incident cases of stage I, II, and III rectal cancer were identified. The number of lymph nodes retrieved in cases receiving preoperative radiotherapy was lower than others. In stage II cases receiving preoperative radiotherapy, retrieval of 7 to 11 lymph nodes (compared with 0 lymph nodes retrieved as a reference) reached the nadir of colorectal cancer-specific mortality benefit (HR = 0.39, 95% CI, 0.28-0.56) and overall mortality (HR = 0.62, 95% CI, 0.48-0.80). In stage II cases with no radiotherapy or postoperative radiotherapy, retrieval of ≥ 12 lymph nodes remained the strongest prognosticator of colorectal cancer-specific mortality (HR = 0.34, 95% CI, 0.25-0.46; HR = 0.36, 95% CI, 0.24-0.53 respectively)., Limitations: : The California Cancer Registry does not include radiation dose and duration, chemotherapy type and dosage, margin status and surgeon characteristics, and stated reasons for lower number of lymph nodes retrieved or patient-related factors. In addition, no central pathology laboratory was used., Conclusions: In stage II rectal cancer cases receiving preoperative radiotherapy vs either postoperative or no radiotherapy, a lower threshold of lymph node retrieval may be sufficient to evaluate prognosis and to guide further therapy.

In addressing health and social issues, there has been a shift since the 1990s to approaches that focus more on making comprehensive community-based changes to affect individual behavior. This article provides an overview of community mobilization to engage community members in the process of addressing social and health issues, discusses current models, and provides a case study. The balance of the article looks at other efforts reported in this supplement, and the ways in which they have used community mobilization as a viable strategy for preventing youth violence.

In December 2001, the Department of Ethnic Studies at California State University, Sacramento initiated a community partnership project with Hiram Johnson High School and Sacramento's Healthy Start to promote ethnic understanding, improve academic performance, and reduce youth violence. This paper presents the community mobilization efforts by this partnership in developing and implementing a community service project to address emerging community-identified social and educational issues. The paper also examines the role of an Ethnic Studies Model in community mobilization and shares its key components.