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Racial and ethnic differences in
colorectal cancer emphasize importance of
screening...Minorities share greater
colorectal cancer risk than Caucasians
Philadelphia, PA,
October 15, 2007 – New research presented at
the 72nd Annual Scientific Meeting of the
American College of Gastroenterology
emphasizes the importance of colorectal
cancer (CRC) screening among racial and
ethnic minorities, who have a higher
incidence of colorectal cancer compared to
Caucasians.
Two studies found more
African-Americans had advanced polyps on the
right side of the colon than Caucasians,
while results from colonoscopy screenings of
Latin Americans revealed similarly high risk
findings to African-Americans.
African-Americans have
a high overall incidence of colorectal
cancer and a greater prevalence of proximal
or right-sided polyps and cancerous lesions.
The right side of the colon includes the
cecum, ascending colon and proximal
transverse colon and cannot be reached by
flexible sigmoidoscopy.
The reasons for higher
incidence rates in African-Americans are
unclear; however, dietary, nutritional
factors, rates of physical inactivity,
variability in screening rates, lower use of
diagnostic testing, and increasing smoking
rates have been most commonly implicated.
Dr. Roy D. Yen and his
colleagues from the University at Buffalo
and the VA Western New York analyzed the
results of 587 colonoscopies (78
African-Americans, 502 Caucasians) performed
at their institution in 2004.
The number and location
of polyps and presence of advanced lesions
between the two cohorts were examined. They
found significantly more African-American
patients (14 percent) had advanced
right-sided, or proximal, polyps compared to
Caucasian patients (5.4 percent).
Researchers also found more black patients
had advanced polyps, proximal polyps and
proximal colon cancers than whites.
Based on the results of
this study, “Flexible sigmoidsocopy may be
inadequate for colorectal cancer screening
in this population. African Americans should
undergo colonoscopy with particular
attention for proximal lesions, however
larger prospective studies are needed to
confirm these findings,” said Dr. Yen.
Colonoscopy Among Latin
Americans Reveals Similar Incidence of High
Risk Findings to African-Americans
In a retrospective
analysis conducted at The University
Hospital and the New Jersey Medical School
in Newark, NJ, Dr. Stanley H. Weiss, Dr.
Mark J. Sterling, and their research team
reviewed screening colonoscopies performed
in 2005 and 2006. They found Latin Americans
had a higher than expected incidence of
polyps, pathologically significant lesions,
and significant right-sided lesions, similar
to previously reported findings in
African-American patients.
Of the 756 screening
colonoscopies, 287 (38 percent) were in
Latin Americans and 331 (44 percent) were in
African-Americans. Forty-eight percent of
Latin Americans had pathologically
significant lesions, compared to forty-six
percent among African-Americans.
The percentage of
pathologically significant right-sided
polyps was similar in Latin Americans (57
percent) and African-Americans (62 percent).
However, researchers found that
African-Americans were significantly more
likely to have a large polyp (>1 cm) than
Latin Americans and were more likely to have
a large right-sided polyp.
According to study
leader Dr. Stanley H. Weiss, “Because
right-sided lesions are detectable with
colonoscopy, which examines the whole colon,
but not by flexible sigmoidoscopy, these
findings have important implications for
appropriate screening for colon cancer in
Latin Americans.”
About
Colorectal Cancer Screening
Colorectal cancer is
the second leading cause of cancer deaths in
the United States, second only to lung
cancer. The ACG recommends that for
average-risk individuals, colorectal cancer
screening tests begin at age 50. The
preferred approach is a screening
colonosocopy every 10 years, but an
alternate strategy consists of a stool test
for blood every year and flexible
sigmoidoscopy every 3 to 5 years. For
high-risk individuals, screening colonoscopy
may begin earlier and is performed more
frequently.
Physician experts from
the American College of Gastroenterology in
2005 issued new recommendations to
healthcare providers to begin colorectal
cancer screening in African- Americans at
age 45 rather than 50. Colonoscopy is the
preferred method of screening for colorectal
cancer and data support the recommendations
that African-Americans begin screening at a
younger age because of the high incidence of
colorectal cancer and a greater prevalence
of proximal or right-sided polyps and
cancerous lesions in this population. The
recommendations were published in the March
2005 issue of The American Journal of
Gastroenterology.
About
the American College of Gastroenterology
Founded in 1932, the
American College of Gastroenterology (ACG)
is an organization with an international
membership of more than 10,000 individuals
from 80 countries. The College is committed
to serving the clinically oriented digestive
disease specialist through its emphasis on
scholarly practice, teaching and research.
The mission of the
College is to serve the evolving needs of
physicians in the delivery of high quality,
scientifically sound, humanistic, ethical,
and cost-effective health care to
gastroenterology patients.
The ACG is committed to
providing accurate, unbiased and up-to-date
health information. Visit the ACG Web site
www.acg.gi.org to access
educational resources for patients and their
families spanning the broad range of
digestive diseases and conditions - both
common and not-so-common.
Organized by disease,
state and organ system, these educational
materials, developed by ACG physician
experts, are offered for the information and
benefit of patients and the public.
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