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Colon Cancer Hits Early in Blacks, Hispanics

Many Cases of Colorectal Cancer Begin in 40s in These Groups
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WebMD Health News

Nov. 1, 2004 (Orlando) -- New research suggests colorectal cancer strikes blacks and Hispanics earlier than whites.

According to the researchers, the findings underscore the need to start colorectal cancer screening earlier for some groups. "We should start screening African-Americans and Hispanics beginning at age 40," says Raymundo Romero, MD, a gastroenterology fellow at Charles R. Drew University of Medicine and Science in Los Angeles.

The American Cancer Society recommends that beginning at the age of 50, people who are at risk for developing colorectal cancer should receive regular colorectal cancer screening.

Romero tells WebMD that in the black and Hispanic community, "we are diagnosing colorectal cancer in patients under the age of 50." By following the current guidelines, "there are patients who are actually being missed."

Worse yet, he says, is that when colorectal cancer is found in blacks and Hispanics it is often more advanced than cancers found in whites over the age of 50.

"When I saw a 26-year-old with colorectal cancer, I asked myself, 'What is going on here?'" he explains.

At that point, Romero investigated the colorectal cancer literature and discovered an earlier study of all colon cancer cases among blacks and Hispanics living in California from 1993 to 1997. In that study, more than 11,600 colon cancer cases were identified, and of those roughly half occurred in patients younger than 50.

In his study, Romero analyzed data from colon cancer cases in patients who were treated at the Martin Luther King-Drew Medical Center from January 1996 to May 2004.

There were 148 colon cancer cases in blacks and Hispanics during the study period, and 38 of these cases occurred in patients younger than 50. On average, blacks were 44 at diagnosis and Hispanics were 39.

"As you can see from our data, most of the subjects [had more advanced cancer], and the majority of patients are between 40 and 49," says Romero.

Douglas K. Rex, MD, professor of medicine at Indiana University School of Medicine in Indianapolis and outgoing president of the American College of Gastroenterology, tells WebMD that a number of factors could influence the findings.

"The overall finding is that the fraction of colorectal cancer patients in African-Americans and Hispanics under the age of 50 is higher than the fraction of the cases that occur in whites. There is a large percentage of the overall number of cases here that are occurring in younger people. That is an important observation," Rex says.

But he cautions that other studies have suggested that the incidence of colorectal cancer is actually "lower in Hispanics and Asians than it is in whites. So it is difficult to interpret whether the conclusions in this study are right for Hispanics."

Nonetheless, Rex says the study confirms other studies that reported a higher incidence of colorectal cancer in blacks. "I would agree with what they are saying about African-Americans, for sure. It does make sense to begin screening in African-Americans earlier."

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