Research Says Minorities More Likely to Develop Colorectal Polyps

In May, a study from New York-Presbyterian Hospital and Columbia University Medical Center showed that African-Americans and Hispanics have a higher risk for developing precancerous colorectal polyps when compared to Caucasians.

These precancerous polyps are called adenomas. Of cancers that affect both men and women, colorectal cancer is the second-leading cancer killer in the U.S. according to the Centers for Disease Control and Prevention (CDC).

A colorectal cancer refers to the colon and rectum, which together make up the large intestine. Most colorectal cancers begin as polyps – abnormal growths inside the colon or rectum, and may over time, become cancers and about three-fourths of colorectal cancers occur in people with no known risk factors.

Candice P. Jantz, M.D.,  a gastroenterologist answers some questions and gives more details about the study.

Q:  What new information did the study reveal about colorectal cancer in Hispanics and African Americans?

African Americans and Hispanics have a higher risk of developing precancerous colorectal polyps compared with whites and have a higher incidence of developing polyps in the upper portion of the colon as well as being more likely to have advanced adenomas which tend to be more aggressive.

Q:  What ethnic groups have physicians traditionally considered at higher risk for colorectal cancer?

African-Americans and Jews of Eastern European descent (Ashkenazi Jews) have a higher colorectal cancer risk.

Q:  The study indicated that Hispanics are becoming at higher risk for colon cancer through acculturation.  What does that mean? 

As Hispanics adopt a “Western” lifestyle (high fat, low fiber diet, obesity, sedentary lifestyle….), the risk of colon cancer increases.

Q:  The study recommended colonoscopy as a preferred screening test instead of a sigmoidoscopy. What is the difference between the two screening tests?  Why did the study authors prefer a colonoscopy as a screening tool for Hispanics and African-Americans?

A colonoscopy evaluates the entire colon.  A flexible sigmoidoscopy only evaluates the lower portion of the colon.  If there are polyps or cancer higher up in the colon, a sigmoidoscopy will miss them.  Due to the higher risk of African-Americans and Hispanics developing polyps in the upper portion of the colon, a complete examination with colonoscopy is necessary to visualize this area and to remove the polyps if needed.

Q:  Why is it important to screen for precancerous colorectal polyps?

Screening colonoscopy allows a better chance of finding colorectal cancer at an early stage, when it is most curable and allows physicians to discover and remove colon polyps before they turn cancerous so it can help prevent colon cancer.

Q:  What can people do to reduce their risk of colorectal cancer?

Check with your primary care physician about when to start screening for colon cancer. There is strong scientific evidence that having regular screening tests for colorectal cancer beginning at age 50 reduces deaths from colorectal cancer.

Eat healthy (high fiber (fruits/vegetables/whole grains, low fat diet), limit consumption of red meat/processed meats, smoking cessation, limit alcohol intake, maintain a healthy weight, and be physically active (exercise).

Q:  What are the warning signs of colorectal cancer?

Patients may not experience any symptoms in the early stages of the disease. As it becomes more advanced, a person  may notice a change in bowel habits including diarrhea or constipation, change in caliber or in the consistency of the stool, blood in stools, abdominal pain, feeling of incomplete evacuation, weakness, fatigue, and unexplained weight loss.

Q:  How can people learn more about colorectal cancer screening programs?

Click on this link to learn about a program, Screening for Life, from the Centers for Disease Control.

The original paper is titled, “Risk of colorectal adenomas and advanced neoplasia in Hispanic, black and white patients undergoing screening colonoscopy.”  The other co-authors are Kristina Capiak and Alfred I. Neugut, at New York-Presbyterian Hospital and Columbia University Medical Center.

This blog post was contributed by Candice P. Jantz, M.D., a gastroenterologist on the medical staff at Baylor Medical Center at Carrollton.

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Research Says Minorities More Likely to Develop Colorectal Polyps