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Colorectal Cancer Screening: for African Americans, It's about Prevention, Not Just Detection

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SOURCE National Cancer Institute

By the National Cancer Institute

Editor's Note:  The following article is part of the monthly Lifelines education and awareness print series that the National Cancer Institute provides to African American news and information outlets.

BETHESDA, Md., March 15, 2013 /PRNewswire-USNewswire/ -- If a screening test could not only catch cancer early but also help to prevent it, could you think of any reason not to have the test?

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All widely used cancer screening tests aim to detect cancer early, when treatment may be more successful. But several screening tests can also help find abnormal cells that have not yet become cancer, allowing them to be removed before they can cause problems. Colorectal cancer screening tests, for example, can help detect pre-cancerous growths called polyps. Removing these polyps prevents them from becoming cancer.

Colorectal cancer is the third most commonly diagnosed cancer in both African American men and women. More than 18,000 new cases of colorectal cancer are diagnosed in African Americans annually. And, although colorectal cancer rates overall are declining in the United States, the rates for African Americans are decreasing more slowly than the rates for white Americans. African Americans are also more likely to be diagnosed when colorectal cancer is advanced and, therefore, less treatable.

Between 2002 and 2008, the likelihood of surviving 5 years after a diagnosis of colorectal cancer was only 57 percent for African Americans, compared with 65 percent for white Americans. The difference between African Americans and whites in colorectal cancer death rates has actually widened over the years.

Although many factors underlie these disparities, an important one is that African Americans are less likely to be screened for colorectal cancer than whites. For example, in 2010, only 56 percent of African American men and women over the age of 50 had been recently screened for colorectal cancer, compared with 62 percent of white Americans.

A large 2005 survey carried out by the National Cancer Institute, called the Health Information National Trends Survey, found that many African Americans do not know that, when colorectal cancer is caught early, survival rates are good. In fact, surgery can cure about 90 percent of people with early-stage colorectal cancer. March is Colorectal Cancer Awareness Month-a good time to get the facts about how screening and early detection of colorectal cancer can benefit you, your family, and your community.

Several effective options for colorectal cancer screening exist, which means that you can find a test that fits your risk, your concerns, and your comfort level. Knowing your options can make it easier for you to ask your doctor for more information.

• Colonoscopy or sigmoidoscopy: A doctor uses a thin lighted tube to physically check the colon and removes any polyps. Your doctor will give you special laxatives to take before the procedure to clean out your colon. With colonoscopy, you will have sedation (you are asleep during the procedure), and the doctor will check your entire colon. With sigmoidoscopy, you may not need sedation, but the doctor can check only half the colon. Current guidelines recommend that people have a colonoscopy every 10 years or a sigmoidoscopy every 5 years if no polyps are found.
• Fecal occult blood test (FOBT), also known as a stool test: For this test, you use a kit at home to take one or more samples of stool. The sample is sent to the doctor's office or lab to be tested for traces of blood. Some people prefer the stool test because it is done in private, is inexpensive, doesn't require taking laxatives, and is simple to perform. Current guidelines recommend that people who choose FOBT screening have the test every year.
• "Virtual" colonoscopy, also called CT colonography: This procedure uses an imaging test, similar to an x-ray, to look at the inside of the colon without actually putti0ng a tube into the colon. If you have CT colonography you still need a laxative treatment to prepare your colon for the exam. But you won't need sedation. If the procedure does find polyps, you will need a follow-up colonoscopy to remove them. This procedure is new, and many insurance companies do not pay for it. Current guidelines recommend that people who choose CT colonography get the exam every 5 years, if no polyps are found.

Most guidelines recommend that people at average risk of colorectal cancer begin screening at age 50 and continue until age 75. If you are over 50 and have never been screened for colorectal cancer, ask your healthcare provider about which of these tests is right for you. You can also ask about lifestyle changes that may reduce your risk of colorectal cancer. If someone in your family has had colorectal polyps or cancer, you may need to start screening before age 50. Again, your healthcare provider is the place to start.

Not having health insurance can keep people from getting screened. If you are uninsured or underinsured, the Centers for Disease Control and Prevention has a program in 25 states that provides colorectal cancer screening services to low-income men and women aged 50–64 years. More information on this program can be found at cdc.gov/cancer/crccp. For those with insurance, screening for colorectal cancer is covered under the Affordable Care Act for people over age 50. Depending on your insurance plan, you may be able to get tested at no cost to you.  

To learn more about colorectal cancer, visit the National Cancer Institute (NCI) website at www.cancer.gov (search term: colorectal) or call 1-800-4-CANCER (1-800-422-6237). NCI has a variety of information on colorectal cancer risk, prevention, screening, treatment, clinical trials, and a host of other topics.

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI web site at www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237). More articles and videos in the culturally relevant Lifelines series are available at www.cancer.gov/lifelines.

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