Colon cancer screenings recommended at 45 for African Americans

According to the American Cancer Society, there were about 108,070 new cases of colon cancer and 40,740 new cases of rectal cancer in 2008. Overall, the two cancers caused nearly 50,000 deaths last year.

Colonoscopies and other screening tests have played important roles in the steady decline of deaths caused by colon cancer in recent years. Still, colorectal cancer remains the third deadliest form of cancer in America. For unknown reasons, the disease affects more African Americans than any other group in America. And it does so with more deadly consequences than in any other group.

The American Gastroenterological Association now recommends that African Americans undergo colorectal cancer screening beginning at age 45, according to Romnee Clark, M.D., associate professor of clinical medicine at the Indiana University School of Medicine and researcher at the Indiana University Melvin and Bren Simon Cancer Center.

Risk factors
Adults from other races should begin colorectal cancer screening at age 50 unless they have other risk factors, such as:

• a personal history of colorectal cancer
• a personal history of chronic inflammatory bowel disease
• a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60, or in two first-degree relatives of any age)
• a known family history of hereditary colorectal cancer syndromes

Colonoscopy
During a colonoscopy, a doctor is able to directly see the entire colon. If a polyp is found, it may be removed and tissue may be sent to the lab to see if any cancer is present. By removing a polyp, cancer cells can't develop.

"It's important to understand that removal of an abnormal polyp is a form of colon cancer prevention," Dr. Clark said. "Removal of polyps during colonoscopies is the most effective form of colon cancer prevention."

Dr. Clark also pointed out that people can alter their lifestyles to decrease the risk of developing colorectal cancer. She said eating a diet rich in fiber, fruit and vegetables, quitting or never smoking, drinking alcohol in moderation, exercising and maintaining a healthy weight can all help in the long run.

"These decisions are good for your heart, your lungs, and your mind," she said. "They're good for preventing other illnesses in general, not just colorectal cancer."

Virtual colonoscopy
In addition to traditional colonoscopy, virtual colonoscopies are available, Dr. Clark added. Virtual colonoscopy is also known as computerized tomography (CT) colonography.

In a virtual colonoscopy, images of the large intestine are taken using CT scans. A computer puts the images together to create a three-dimensional view of the inside of the large intestine. The procedure takes about 10 minutes and does not require sedation.

Talk with your physician about the pros and cons of the different types of screening tests to find the best one for you.

How is colon cancer treated?
As with most cancers, treatment for colon cancer may include surgery, radiation therapy, and chemotherapy. Depending on the stage of the cancer, two or even three types of treatment may be used at the same time or in sequence.

Clinical trials
For some people, clinical trials are an option. They are open to people either with a high risk for cancer or diagnosis of the disease. The IU Simon Cancer Center is conducting a number of colorectal clinical trials. For more information, visit http://www.cancer.iu.edu/patients/trials/ or call (317) 274-0972