Colorectal cancer is the fourth most common cancer diagnosis in the United States, and while a cure is possible if detected early, it is one of the leading causes of cancer deaths in African Americans. According to the National Library of Medicine, incidence rates of colorectal adenomas are 23% higher in African American males and 22% higher in African American females than their caucasian counterpart. New information is being developed to help us better understand the connection between a rise in colorectal adenomas and the potential for cancer in African Americans.
Colorectal adenomas are gland-like growths that develop in the large intestine. While most are benign, some become cancerous and can spread. The most common types of adenomas are tubular polyps and villous adenomas. Tubular polyps protrude out into the open space of the colon, known as the lumen. Villous adenomas are flat and traditionally spread, often becoming cancerous. When an adenoma becomes cancer, it is called an adenocarcinoma and is the most common type of colorectal cancer. The bigger the polyp or adenoma, the greater the chance of it becoming cancer. Usually there are no symptoms associated with adenomas or polyps in the colon. This is why regular screening is so important. However, in more severe cases, you may experience symptoms like abdominal pain, a change in your bowel movements, rectal bleeding, or even an iron deficiency.
Men and women over the age of 50 are at a higher risk for developing a colorectal adenomas. However, if you have a family history of colorectal cancer or colorectal polyps, you may benefit from an early screening. Obese or overweight adults are also at a high risk, including those who suffer from an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis. Risks are also higher for anyone who does not have a well controlled diagnosis of type 2 diabetes or consume alcohol and tobacco products regularly. Potentially, the greatest risk factor is race. African Americans are much more likely to develop colorectal adenomas and even colorectal cancer than any other race.
One reason doctors believe the diagnosis of African Americans with colorectal cancer is so much higher is due to a lack of screening. Typically, African Americans are half as likely as Caucasians to receive a colonoscopy. Waiting until the cancer has spread to the colon and making treatment more difficult may be the reason colorectal cancer death is so much higher as well. Recently, 52 patients underwent free colonoscopy screenings at Howard University Hospital, 47 of whom were black. Of the African American female patients, 81% had adenomas and 43% had advanced adenomas. The results from African American male patients showed 92% had adenomas and 28% had advanced adenomas. This information was then compared to screening results of white and Hispanic patients and the African American percentages were significantly higher. While more studies need to be conducted, this research indicates the greater risk of contracting colorectal adenomas, and potentially colorectal cancer, in both men and women of African decent. This may be the first study to jumpstart research that determines whether or not African Americans need to be screened earlier than the current recommend age of 50. Colon cancer can be successfully treated—even prevented— if colorectal adenomas are caught early. In fact, there are currently 1 million colorectal cancer survivors in the United States. This is not a hopeless diagnosis, but it is important to be aware of the risks and the necessity of early detection.
If you are over the age of 50 or have a family history of colorectal cancer, contact us at Carolina Digestive Health Associates to schedule a screening today. Don’t be afraid of a colonoscopy, it may be the very thing that saves your life! If you are African American it may be in your best interest to schedule a screening even earlier than your 50th birthday to ensure a colon free of adenomas and free of cancer. If you have any questions, we are here to help!