African American Health

Colorectal Cancer and African Americans

Colorectal cancer is the second overall cause of cancer death in the United States. According to the American Cancer Society, an estimated 145,290 new cases were diagnosed in 2005, and 56,290 deaths occurred. Both men and women can develop cancer of the colon and rectum, and their risk increases over the age of 50. African Americans are particularly affected by colorectal cancer and have a higher incidence and mortality from colon cancer than non-African Americans.

What we know

The number of new cases of colorectal cancer diagnosed each year in African Americans has not decreased. Of equal concern, is that:

African Americans tend to be diagnosed with colon cancer at a younger age than Whites.
African Americans die sooner from colon cancer once diagnosed.

These differences may be due to:

Not seeing a health care professional regularly
Not undergoing colon cancer screening in a timely manner
Lifestyle habits
Eating a diet high in fat, red meat, or processed meat
Physical inactivity and obesity
Tobacco
Alcohol

Screening for Colon Cancer

Screening can in most cases prevent the development of colon cancer by removal of precancerous polyps before they progress to cancer. Also, if colorectal cancer is diagnosed at an early stage, the chance of a surgical cure is good, and 5 year survival is 90%.

For average-risk individuals (patients without symptoms and without a family history of colon cancer), there are several recommended screening options. Colonoscopy is gaining acceptance as the preferred screening method since it has a therapeutic potential to identify and remove polyps throughout the entire colon. Other screening options include flexible sigmoidoscopy every 5 years, annual fecal occult blood testing (FOBT), and double contract barium enema every 5 years. Each screening test has advantages and limitations that should be discussed with patients to maximize their compliance.

Emerging research also suggests that African Americans are more likely than Whites to have precancerous polyps and colon cancer in the proximal colon, which could potentially be missed if screening was done by flexible sigmoidoscopy alone.

What You Can Do

In response to the higher incidence and mortality of colorectal cancer among African Americans, the American College of Gastroenterology advocates modifying current screening guidelines in this population and recommends screening at the age of 45 rather than age 50.

Current research data also suggests colonoscopy may be the preferred screening procedure rather than flexible sigmoidoscopy because of the greater prevalence of proximal polyps and proximal cancers in African Americans.

Patients commonly have questions, misconceptions, and fears about the need for colon cancer screening. Talk to your primary care physician about screening which is one of the most powerful weapons in preventing colon cancer.

To learn more about colon cancer, check out these NetWellness features:

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Last Reviewed: Jul 12, 2006

Julia Gore Thornton, MD
Assistant Professor
Gastroenterology-Hepatology Division
MetroHealth Medical Center
School of Medicine
Case Western Reserve University