Researchers from Vanderbilt University have reported that 27% of African Americans with a first-degree relative with colon cancer undergo screening colonoscopy compared with 43% for White persons. The details of this study appeared in the March 24, 2008 issue of the Archives of Internal Medicine.¹

Colorectal cancer remains the second leading cause of cancer-related deaths in the United States. If detected early, cure rates for the disease are high. However, cure rates fall dramatically as the cancer advances and spreads from its site of origin. Therefore, screening, preferably with colonoscopy, remains a crucial step in improving survival for patients diagnosed with colorectal cancer. Unfortunately, compliance rates with recommended screening colonoscopy remain low, which is attributed to the invasive nature of the procedure and the associated time commitment. However, even less invasive screening procedures such as sigmoidoscopy, testing for fecal occult blood, and CT colonography are also underutilized.

Compared with the general population, individuals who have a first-degree relative who has been diagnosed with colorectal cancer are at an increased risk of developing the disease. Therefore, it becomes even more important for these people to undergo colonoscopy screening at age 40 years, rather than at age 50 years for the general population. A recent Spanish study showed that if the affected family member was female the screening rate was 46% compared with 31% if the index case was a male. A recent German study showed a compliance rate of 27% for first-degree relatives of patients with colon cancer.

The current study population for compliance with screening colonoscopy included more than 40,000 participants in the Southern Community Cohort. This study looked at patients with multiple affected first-degree relatives or relatives diagnosed before the age of 50 years. They found that 23% of at-risk African Americans had had a colonoscopy within the past five years compared with 43% for at-risk White individuals. When adjusted for age, sex, educational status, annual income, insurance status, and total number of affected and unaffected family members, African Americans were 50% less likely to undergo screening colonoscopy. Increased efforts to identify and screen at-risk populations are recommended.

Comments: These data suggest that screening colonoscopy is low in both African Americans and Whites at risk for colon cancer, but the compliance rate is poorer in African Americans.

Related News:

Persons at High-Risk for Colorectal Cancer not Being Screened (4/30/2007)

Rate of Colorectal Cancer Screening with Colonoscopy in First-degree Relatives Needs Improvement (9/4/2007)

American Cancer Society Releases Cancer Screening Guidelines for 2006 (2/15/2006)

Computed Tomography Colonography Deemed Cost Effective Method of Screening for Colorectal Cancer (6/27/2007)

Room for Improvement in Screening for Colorectal Cancer in Primary Care Setting (10/18/2005)

Physicians Influence Rates of Colorectal Screening (2/20/2008)

Reference:

¹ Huff HJ, Peterson NB, Fowke JH, et al. Colonoscopy screening in African-Americans and whites with affected first-degree relatives. Archives of Internal Medicine. 2008;168:625-631.