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Racial and ethnic differences in colorectal cancer emphasize importance of screening
October 15, 2007New 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."
American College of Gastroenterology
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."
American College of Gastroenterology
Colorectal Cancer Current Events and Colorectal Cancer News RSSHuman genomics in China
Ten years ago, the Chinese National Human Genome Center at Shanghai (South Center, hereafter) was established in the Zhangjiang HiTech Park of Pudong District in Shanghai. To commemorate this important event, which marks the beginning of the Genomics Era in China, we specially organize a series of mini-reviews for this special issue.
Hormone therapy associated with reduced colorectal cancer risk
The combination of estrogen plus progestin, which women stopped taking in droves following the news that it may increase their risk of breast cancer, may decrease their risk of colorectal cancer, according to a report published in the January issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.
Annals colonoscopy study underscores importance of quality standards
A study by Baxter, et al. released this week and scheduled to be published in the Jan. 6, 2009, edition of Annals of Internal Medicine, concluded that while screening colonoscopy is associated with fewer deaths from colorectal cancer, the association is primarily limited to deaths from cancer developing in the left side of the colon.
ASGE urges patients to seek a qualified endoscopist before undergoing a colonoscopy
A study released today in the Annals of Internal Medicine found that colonoscopy is associated with lower death rates from colorectal cancer, however, the procedure missed lesions more often on the right side of the colon versus the left side.
CT colonography offers 1-stop screening for cancer and osteoporosis
New research reveals that computed tomography (CT) colonography, also known as virtual colonoscopy, has the potential to screen for two diseases at once-colorectal cancer and osteoporosis, both of which commonly affect adults over age 50.
Screening for colorectal cancer detects unrecognized disease
Screening for colorectal cancer detects four out of ten cancers and should be carefully designed to be more effective, according to a study published today on bmj.com.
A Simple Blood Test for Colon Cancer
People are often reluctant to undergo a routine but painful colonoscopy ― but the consequences can be fatal. According to the American Cancer Society, colon cancer is the third most common cancer found in American men and women and kills about 50,000 Americans every year.
New platinum-phosphate compounds kill ovarian cancer cells
A new class of compounds called phosphaplatins can effectively kill ovarian, testicular, head and neck cancer cells with potentially less toxicity than conventional drugs, according to a new study published this week in the journal Proceedings of the National Academy of Sciences.
Survival of head and neck cancer patients is greatly affected by coexisting ailments
Current estimates for head and neck cancer survival are largely inaccurate because they widely disregard many of the most common diseases such patients have in addition to their primary cancer, says Jay Piccirillo, M.D., a head and neck specialist at Washington University School of Medicine in St. Louis, the Siteman Cancer Center and Barnes-Jewish Hospital.
Home-based diet and exercise intervention improves elderly cancer survivors' physical function
A home-based program to improve exercise and diet led to significant, clinically meaningful improvement in body weight and physical function among older long-term cancer survivors in preliminary findings from the RENEW (Reach-out to ENhancE Wellness) trial.
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