AIM:To compare the racial differences of anatomicaldistribution of colorectal cancer(CRC)and determine theassociation of age,gender and time with anatomicaldistribution between patients from America(white)and China(oriental).METHODS:Data was collected from 690 consecutivepatients in Cleveland Clinic Florida,U.S.A.and 870consecutive patients in Nan Fang Hospital affiliated to theFirst Military Medical University,China over the past 11years from 1990 to 2000.All patients had colorectaladenocarcinoma diagnosed by histology and underwentsurgery.RESULTS:The anatomical subsite distribution of tumor,age and gender were significantly different betweenwhite and oriental patients.Lesions in the proximal colon(P<0.001)were found in 36.3%of white vs 26.0%oforiental patients and cancers located in the distal colonand rectum in 63.7%of white and 74%of oriental patients(P<0.001).There was a trend towards the redistributionfrom distal colon and rectum to proximal colon in whitemales over time,especially in older patients(>80 years).No significant change of anatomical distribution occurredin white women and Oriental patients.The mean age atdiagnosis was 69.0 years in white patients and 48.3 yearsin Oriental patients(P<0.001).CONCLUSION:This is the first study comparing theanatomical distribution of colorectal cancers in whites andChinese patients.White Americans have a higher risk ofproximal CRC and this risk increased with time.Theproportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC anddeveloped the disease at a significantly earlier age thanwhite patients.These findings have enhanced ourunderstanding of the disease process of colorectal cancer inthese two races. AIM: To compare the racial differences of anatomic disfiguration of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution of patients from America (white) and China (oriental) .METHODS: Data was collected from 690 consecutivepatients in Cleveland Clinic Florida, USA and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectaladenocarcinoma diagnosed by histology and underwentsurgery .RESULTS: The anatomical subsite distribution of tumor, age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P <0.001) were found in 36.3% of white vs 26.0% of patients with cancers located in the distal colon and rectum in 63.7% of white and 74% of oriental patients (P <0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especial ly in older patients (> 80 years) .No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age atdiagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P <0.001) .CONCLUSION: This is the first study comparing theanatomical distribution of colorectal cancers in whites andChinesepatients.White Americans have a higher risk ofproximal CRC and this risk increased with time.Theproportion of white males with CRC also increased with time .Chinese patients were more likely to have distal CRC anddeveloped the disease at a significantly earlier age thanwhite patients.These findings have enhanced our understanding of the disease process of colorectal cancer inthese two races.