COVID-19 Information

What Are My Colon Cancer Screen Options?

Written By: Melissa M. Murphy, MD,  Executive Chief of Surgery, Care New England Health System; Chief of Surgery, Kent Hospital on March 9, 2022


As many tuned in to watch the 2022 Super Bowl half-time show and reminisced to songs like “Next Episode”, “California Love”, and “In Da Club”, you might not have been thinking about the artists’ risk of developing colon cancer. Specifically, the a higher risk among African Americans to develop colorectal cancer. But yes, Snoop Dogg, Dr. Dre, Mary J. Blige, and 50 Cent have all passed the age threshold of 45 when the American Cancer Society recommends starting colon cancer screening. If you sang along to these songs, you may be due too! Learn more about your screening options. 

Numbers
What are the numbers specific to colorectal cancer affecting the African American population in the United States? In 2019, it was estimated nearly 20,000 African Americans were diagnosed with colorectal cancer with over 7,000 deaths. Blacks have the highest rates of colorectal cancer amongst any ethnic group in the US.
  • The American Cancer Society reports African Americans are 20% more likely to develop colorectal cancer and 40% more likely to die from it.
  • Colorectal cancer is the 3rd most common cause of death for African Americans in the United States
  • African Americans get colorectal cancer at an earlier age, present at later stages, and have a lower survival rate than whites.
Increasing Cancer Risk in Young African Americans

In people less than age 50, colorectal cancer has risen by 1.5% annually since 1992 for reasons that are not fully understood.

  • Among African Americans, the rate of young-onset colorectal cancer is nearly twice as common among whites
  • African Americans have worse 5-year survival at every stage when compared to Hispanics or whites at the same stage.
Colon Cancer is Preventable

Approximately 90% of all colorectal cancer cases and deaths are preventable by removing polyps and treating colon cancer when detected early. Why is screening among African Americans lower than for other ethnic groups?

  • Access to healthcare providers and testing 
  • Medical Mistrust
  • There are studies examining why African Americans are less likely to proceed with colorectal cancer screening with some contributory reasons listed below.
    • General mistrust of doctors and the US healthcare system
    • Skepticism of provider motives
    • Fear of experimentation based on historical events
    • Invasiveness of procedure and “perceived” sexual connotation.

It is important for physicians to build relationships with their patients and provide them with the data to help the patients make an informed decision about colorectal cancer screening.

Diet, Genetics, & Lifestyle

African Americans make up a disproportionate number of those with lower socioeconomic status which can directly impact access to healthcare, food, and resources.

  • Diets with more animal fat and less fiber are risk factors for colon cancer
  • Lifestyle factors including tobacco use, obesity, alcohol use, decreased physical activity, and lower intake of Vitamin C and E are related to increased colon cancer risk
  • African Americans are more likely to develop polyps and colon cancer on the “right” side of the colon which can be harder to diagnose early
  • Preliminary data that colorectal tumors in African Americans are more likely to have molecular characteristics associated with worse outcomes including mutations in the KRAS gene (this can affect the ability of the body to repair errors made during DNA replication)
  • African Americans males are more likely to decline a colonoscopy than other groups
Know the Symptoms of Colorectal Cancer

Talk to your primary care doctor if you notice any of the following.

  • Any change in your bowel habits (constipation, diarrhea, narrow stool)
  • Rectal bleeding/blood in your stool
  • Abdominal pain
  • Unexplained weight loss
  • Weakness and Fatigue
  • The sense that you are not completing your bowel movement

Advocate for your health if you have any of these symptoms! But remember, not everyone with colorectal cancer has symptoms which is why screening is SO important.

Screening

The American Cancer Society recommends screening begin at age 45 or earlier if you have other risk factors

  • Family/personal history of colorectal cancer
  • Genetic syndromes (Familial Adenomatous Polyposis Syndrome or Lynch Syndrome)
  • History of Inflammatory Bowel Disease (Ulcerative Colitis or Crohn’s Disease)
  • History of radiation to your abdomen/pelvis

There are different types of tests to screen someone for colorectal cancer.

  1. Visual tests
Colonoscopy
  • When a surgeon/gastroenterologist places a small flexible tube with a camera in your colon while you are comfortable receiving anesthesia. They can identify polyps (and remove them) or find concerning areas like cancer (take biopsies).
  • Repeat every 3-10 years depending on the findings

Virtual Colonoscopy

  • This is an advanced type of CT scan of the colon and rectum that creates a 3D image which can show abnormal areas like polyps or cancers. If there is something concerning on this test a routine colonoscopy needs to be performed
2. Stool based tests

 

Cologuard

  • Stool DNA test used to identify any abnormal sections of DNA from cancer or polyp cells or look for blood.
  • These should be done every 3 years
  • This can be done at home
  • If positive the patient will need a routine colonoscopy

 

Fecal Immunochemical Test (FIT)

  • Looks for hidden blood (occult) in the stool
  • Must be done every year
  • If positive the patient will need a routine colonoscopy
What Should I Do If I Think I Need to be Screened for Colorectal Cancer?

If you are over age 45, have family history of colorectal cancer, or any of the symptoms of colorectal cancer please consult with your primary care provider. If you do not have a primary care provider and want to schedule an appointment for a screening colonoscopy, please call the number below. If you need a primary care doctor can you click the button to schedule an appointment now.

At Care New England we are committed to a culture of diversity, equity, and inclusion. We care about your colon health and want to make sure we provide care to you in a safe, comfortable, and respectful environment. Help us beat COLON CANCER. Get screened today!

Schedule A Colonoscopy

Sign up for latest updates in health and wellness