Check Your Pipes: Colon Cancer Screening

The tragic loss of Chadwick Boseman, an African American actor, highlights the importance of colorectal cancer screening in African Americans. Boseman passed away at 43 from colorectal cancer, which he had been battling privately for four years. His death serves as a reminder that colorectal cancer can affect anyone, regardless of age, race, or socioeconomic status. It is important to understand the guidelines for colon cancer screening.

The American College of Gastroenterology (ACG) has released updated guidelines for colon screening, recommending that individuals should start screening at age 45, regardless of gender. This is a change from the previous guidelines, which suggested screening at age 50. Additionally, the ACG recommends that African Americans begin screening at age 45 due to their higher risk of colon cancer and lower screening rates (Table 1 ).

African Americans are at a higher risk of developing colon cancer than other races, with a 20% higher incidence rate and a 40% higher mortality rate from colon cancer compared to non-Hispanic whites. The reasons for this disparity are not entirely clear, but it may be due to a family history of colorectal cancer, a personal history of inflammatory bowel disease, a diet high in red and processed meat, obesity, and physical inactivity. African Americans are also more likely to be diagnosed with colorectal cancer at an earlier age and more advanced stage, highlighting the importance of early screening.

There are several types of colon screening available, including:

• Fecal immunochemical test (FIT): This test detects hidden blood in the stool and is done every year.
• Stool DNA test: This test detects changes in DNA that may indicate colon cancer and is done every three years.
• Colonoscopy: This test is done every ten years and involves inserting a thin, flexible tube with a camera into the rectum and colon to look for polyps or other abnormalities (Diagram 1).
• Flexible sigmoidoscopy: This test is done every five years and involves inserting a thin, flexible tube with a camera into the rectum and lower colon to look for polyps or other abnormalities.
• CT colonography: This test is done every five years and uses x-rays and computer technology to create detailed images of the colon.

It is important to see a doctor if you experience any symptoms of colorectal cancer, such as (but not limited to):
• Rectal bleeding
• Abdominal pain
• Changes in bowel habits
• Unexplained weight loss.

There are ways to decrease the risk of colon cancer, including:
• Maintaining a healthy weight,
• Being physically active
• Avoiding smoking and excessive alcohol consumption
• Consuming a healthy diet that includes fruits, vegetables, and fiber
• Having regular colon cancer screening

In conclusion, colorectal cancer screening is crucial for African Americans, who have a higher incidence and mortality rate of this disease. It is essential to know your family history, follow a healthy lifestyle and diet, follow the recommended screening guidelines, and talk to your doctor about any risk factors you may have. If you experience any symptoms of colorectal cancer, it is essential to see a doctor. Chadwick Boseman’s untimely death is a reminder of the importance of early detection and prevention of colorectal cancer.

References

• American Cancer Society (2023). Colorectal Cancer Screening Guidelines. Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-guidelines.html.
• American Cancer Society (2023).Colorectal Cancer Screening Tests. Retrieved from https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html
• American College of Gastroenterology (2022). ACG Updates Guidelines for Colorectal Cancer Screening. Retrieved from https://gi.org/2022/01/06/acg-updates-guidelines-for-colorectal-cancer-screening/
• American Society of Clinical Oncology. Colorectal Cancer: Statistics (2022) https://www.cancer.net/cancer-types/colorectal-cancer/statistics
• Chadwick Boseman Foundation (2022). Retrieved from https://www.chadwickbosemanfoundation.org
• Fischbach LA, Goodman M, Porterfield D, et al. (2020). Assessing disparities in colorectal cancer mortality by socioeconomic status, race, and stage: A longitudinal ecological study. PLoS One, 15(5):e0233083.
• Mayo Clinic (2023). Colonoscopy. Retrieved from https://www.mayoclinic.org/tests-procedures/colonoscopy/about/pac-20393569