Colon cancer tests should begin earlier in blacks

The American College of Gastroenterology now recommends that Colorectal cancer screening begin at age 45 for African-Americans, instead of age 50, which is recommended for the general population.

Because there are significant differences between blacks and whites in how they are affected by Colorectal cancer, Dr. Sangeeta Agrawal and colleagues at the American College of Gastroenterology extensively reviewed published literature on colorectal cancer screening. They discuss their findings and recommendations in the March issue of the American Journal of Gastroenterology.

Research shows that African Americans have higher rates of colorectal cancer than any other racial or ethnic group in the United States. Because African Americans also tend to be diagnosed at more advanced stages of the disease and their survival rates are lower than other groups at any cancer stage, the authors recommend that screening begin at age 45.

African Americans also tend to have tumors located higher in the colon. Because these tumors can't be detected by sigmoidoscopy alone, Agrawal's team recommends that colonoscopy be considered the preferred screening method for this group.

"Gastroenterologists should play an active role in educating the public and primary care physicians about special issues surrounding colorectal cancer in African Americans," using culturally sensitive patient education programs, the authors conclude.

SOURCE: American Journal of Gastroenterology, March 2005.