Posted Sept. 23, 2008 – There’s evidence that when compared with Whites, Blacks get colon cancer more often and die from it more often.
Since 1985, colon cancer rates have dipped 20 percent to 25 percent for Whites, while rates have increased for African-American men and stayed the same for African-American women, researchers from the Veterans Administration Medical Center in Portland say.
African Americans also are 38 percent to 43 percent more likely to die from colon cancer than are Whites, they add.
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But when it comes to whether race alone is a factor in the higher incident and death rates, Dr. Otis Brawley, chief medical officer of the American Cancer Society, puts on the breaks.
He said the conclusions the Oregon researchers reached from the data are flawed because the study doesn’t take into account socioeconomic factors as well as the fact the Blacks tend to get fewer screenings, and, as a consequence, tend to have more advanced cancers and larger polyps because their cancers are found later.
"We've known for some time that Blacks are less likely to get screened for colorectal cancers than Whites and that their cancers are detected at a later stage,” he says. “Studies looking into this have indicated that access to regular screening rather than biology drives much of this difference.”
For the Portland study, researchers looked at where polyps (larger than 9 millimeters) were located in African-Americans and Whites who were screened but had no symptoms. They also compared how prevalent those polyps were in both races.
Information from colonoscopy screenings of 5,464 African-Americans and 80,061 Whites from 67 screening centers around the United States revealed that "asymptomatic Black men and women undergoing colonoscopy screening are more likely to have one or more polyps sized more than 9 mm, compared with White individuals,” the researchers wrote. “The differences were especially striking among women."
Brawley says, however, that the size of a person’s polyps may be affected by a number of things, including when in the person’s screening is taken and whether the person had ever been screened before.
“They [the Oregon researchers] conclude that the biology of colorectal cancer in Black Americans may be different than in Whites and that in individuals over the age of 60, current screening methods may be less beneficial in Black Americans than in White Americans,” Brawley says. “An accurate assessment of the underlying differences documented by this data demands we correct for socioeconomic status and related polyp risk factors, and for health seeking behaviors when doing Black-White comparisons."
Brawley does, however, agree with the researchers that colon cancer screenings are important for people of all races. For more on colon cancer to Cancer.org.