CANCER: AFRICAN AMERICANS
Some recent studies have suggested that African American females may be at increased risk for colorectal cancer and colon polyp. New recommendations from the American Society of Gastroenterology state that African American females should begin screening for colorectal cancer at age 45 rather than at age 50.
Question: I am an African-American male. My father survived colon cancer 3 years ago. What does this mean for me? In particular, how often should I be checked for colon cancer? What is the best procedure for checking?
Answer: Colon cancer is the second most common cancer in the United States. Colon cancer typically starts as a small polyp--an outgrowth in the colon that's normal, but has the potential to develop into cancer. On average, it takes approximately 10 years for a polyp to become cancerous. Because this takes so long, screening examinations allow "early detection"--identification and removal of polyps before they become cancerous. Because of this, colon cancer is considered a very preventable disease. Unfortunately, many people still fail to undergo appropriate screening to prevent colon cancer.
Guidelines have been developed by special groups to determine the most appropriate screening procedures. In general, everyone age 50 and older should have some type of screening for colon cancer. This screening can involve yearly testing of the stool for blood, flexible sigmoidoscopy, or both. Screening the stool for blood uses a special lab card that allows the patient to take a sample of stool at home and send it to the lab for analysis. Sigmoidoscopy is a procedure where a doctor uses a special camera to look at the last part of the colon. These two procedures are recommended as the mainstay of colon cancer screening. Other procedures, such as colonoscopy and barium enema, are sometimes used.
People with family members who had colon cancer are at increased risk to develop colon cancer themselves. It is generally acknowledged that if more then one family member has developed colon cancer, screening should begin at a younger age. Also, people in families with a history of many colon polyps should begin screening at a younger age. Recommendations for people who have had only one family member develop colon cancer vary depending on a number of factors, including the age of the relative and the age of the patient in question.
A high-fat, low-fiber diet is a risk factors for colon cancer. Some cultures, like certain groups in Africa, have a diet that is very high in fiber and low in fat, and they have lower rates of colon cancer. But when people from these cultures move to the United States and adopt the typical low-fiber, high-fat, American diet, their risk of colon cancer increases to that of the average American. For this reason, recommendations for colon cancer screening are the same for all races living in the United States.
All persons age 50 or older or with a family history colon cancer should see their doctors. At that visit, patients should learn about strategies to prevent colon cancer and decide on the most appropriate plan of action.
