African Americans face higher colon cancer risk, should have screening colonoscopy earlier

General guidelines recommend that most adults have a screening colonoscopy every 10 years beginning at age 50; for African Americans, however, the recommended age drops to 45. Why the difference? Research shows that African Americans are being diagnosed with colorectal cancer more frequently and at a younger age than any other group.

There may be genetic factors that contribute to the higher incidence of colorectal cancer among some African Americans. Type 2 diabetes, for example, a disease more prevalent in the African-American population, is a known risk factor for colorectal cancer. The higher levels of glucose and insulin are believed to create an environment that promotes the development and growth of cancer.

Colorectal cancer is preventable and largely curable if caught early. Precancerous and benign polyps are removed in about half of people who have screening colonoscopies. The preventive screening is covered fully by most insurance plans for people who are 50 or younger with risk factors.

At this point, researchers have not pinpointed the reason behind the disparities, but they do report some troubling statistics when it comes to colorectal cancer and the African-American population:

  • The incidence of colorectal cancer is higher among African Americans than any other population group in the United States.
  • Death rates from colorectal cancer are higher among African Americans than any other population group in the United States.
  • There is evidence that African Americans are less likely than Caucasians to get screening tests for colorectal cancer.
  • African Americans are less likely than Caucasians to have colorectal polyps detected at a time when they can easily be removed.
  • African Americans are more likely to be diagnosed with colorectal cancer in advanced stages when there are fewer treatment options available. As a result, they are less likely than other populations to live five or more years after being diagnosed.
  • African-American women have the same chance of getting colorectal cancer as men.
  • African-American patients are more likely to have polyps in the deeper portion of the colon, where polyps are impossible to detect without a colonoscopy.

In its most recent report on colorectal cancer, the American Cancer Society shared the good news that increased screening (more colonoscopies) among adults age 50-75 is working. The incidence of colorectal cancer in older adults has dropped by 30 percent over the last 10 years, with similar declines in the death rate attributed to the disease.

One troubling aspect of the report was that similar declines were not present in the African-American population, due at least in part to fewer people in that population group undergoing colonoscopies.