Colon Cancer and Blacks

Colorectal cancer (CRC) remains the third most common cause of malignancy-related death in men and women in the United States. Each year, about 140,000 Americans are diagnosed with colon cancer, and more than 50,000 die from it. That’s bad news, but for African Americans, it’s even worse.

African Americans are more likely to get colon cancer; they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer; they’re more likely to die from colon cancer and they have shorter survival after diagnosis with colon cancer.

The colon travels up the right side of the body, across, and back down the left side, ending with the rectum. Sometimes small bumps form, called polyps. Not all of them become cancerous, but there are a number of ways to screen for polyps and remove them. Fecal tests can detect blood or cancerous DNA. There’s a colonoscopy, in which a long, thin tube is inserted in the rectum. A tiny camera examines the right and left side of the colon. It sounds painful, but if you get one, you are asleep and don’t feel a thing. There’s also something called a flexible sigmoidoscopy.

The problem with a flexible sigmoidoscopy test is that African Americans are more likely to develop polyps deeper in the colon, on the right side. According to the National Center for Health Statistics at the Centers for Disease Control and Prevention, 1 in 41 Black males will die from colorectal cancer, compared to 1 in 48 White males. The risk is similar for women. One in 44 Black females will die from colorectal cancer, compared to 1 in 53 White females. But African American men are especially likely to refuse a colonoscopy.

So, diets that are very high in fat, particularly animal fat, and very low in fiber, are associated with developing colon cancer later in life.

Other lifestyle factors among African Americans – higher tobacco-related illness, more obesity, less physical activity, and lower intake of vitamins C and E – are also thought to be tied to colon cancer. Another factor, particularly for African Americans, has to do with the idea that if you’re going to die from cancer anyway, you’re better off not knowing about it. Even though the purpose of the screening is to find polyps before they become cancerous.

With proper screening and lifestyle adjustments, the incidence of colon cancer can be decreased significantly. The American Institute for Cancer Research recommends at least 30 minutes a day of moderate activity for cancer prevention.

Colorectal cancer in African American men is often discovered in its later stages, not only because the lack of health care keeps many of them from going to the doctor, but also because cultural taboos cause many who have medical coverage not to respond to the early warning signs.

Talking to family and friends about their risk and the need for screening as well as community outreach and education programs, along with regular scheduled physician checkups and colon cancer screening can go a long way in preventing colon cancer. If found early enough, colon cancer can be treated effectively and cured.

The American Cancer Society (ACS) has released an updated guideline for colorectal cancer screening. Among the major guideline changes, the new recommendations say screening should begin at age 45 for people at average risk. Previously, the guideline recommended screening began at age 50 for people at average risk.  Recommendations for screening test options are also part of the guideline changes.

New screening age recommendations for those at average risk:

  • People at average risk of colorectal cancer should start regular screening at age 45.
  • People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.
  • People ages 76 through 85 should make a decision with their medical provider about whether to be screened, based on their own personal preferences, life expectancy, overall health, and prior screening history.
  • People over 85 should no longer get colorectal cancer screening.

REMEMBER THESE IMPORTANT FACTS:

  • The rate of being diagnosed with colorectal cancer is higher among African Americans than among 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.
  • Experts suggest that African Americans get screened beginning at age 45.
  • Diet, tobacco use and a lack of access to equal medical treatment options may increase African Americans’ risk of developing colorectal cancer.
  • African American patients experience a larger number of polyps on the right side of the colon, versus the left. A screening endoscopy must cover the entire colon, as is performed with a colonoscopy.

Talking to family and friends about their risk and the need for screening as well as community outreach and education programs, along with regular scheduled physician checkups and colon cancer screening can go a long way in preventing colon cancer.

If found early enough, colon cancer can be treated effectively and cured.

Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice.

The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. He is a health columnist and radio commentator who lectures, nationally and internationally on health related topics. For more good health information listen to Glenn, on radio in Philadelphia; Boston; Shreveport; Los Angeles; and Birmingham., or visit: www.glennellis.com