Colon Cancer in African Ameri... Video Transcript

Participants

, Eric R. Lemmer MD, PhD, Kenneth Brown MD

Summary

Colon cancer, which is the second leading cause of cancer deaths, typically strikes African-American men and women at a younger age. Learn what you need to know about early screening and preventing the disease.

Webcast Transcript

ANNOUNCER: In the US, colorectal cancer is the second most common cancer in African American women, and the third most common cancer in African American men. And although the incidence of colorectal cancer has stabilized over the last two decades, the incidence rates are still higher in African Americans than the rest of the population. Unfortunately, colorectal cancer is not always well understood by many of those at risk. Dr. Kenneth Brown of Providence Hospital in Washington, DC, explains the basics of this disease.

KENNETH BROWN, MD: Colon cancer is a growth within the tube of the large bowel that can cause a number of symptoms, including weight loss, bleeding, abdominal pain, and it's present in about six percent of the population. Two percent of all deaths are caused by colon cancer.

ANNOUNCER: There are several types of colon cancer but one is the most prevalant.

KENNETH BROWN, MD: The basic type of colon cancer is called adenocarcinoma. It's a glandular cancer. And there are other varieties, but this is the main type; the other varieties are very rare. And the glandular cancer is the type that is predominant in our country.

ANNOUNCER: Risk factors for colorectal cancer include: family history; ethnic background; a history of polyps or previous colorectal cancer; inflammatory bowel disease, such as ulcerative colitis; a diet high in fat; physical inactivity; smoking; excessive alcohol consumption; and increasing age.

KENNETH BROWN, MD: Certainly, over the age of 50 to 60 years, the incidence increases, so it's a disease of late middle age and early elderly people. Certainly, it may affect the African American community at a younger age and that's why the screening recommendations have been changed so that in African Americans, probably new recommendations are around age 45. In general, prior to the last year or so, it was recommended at age 50. Now, if you have a family history with early onset of colon cancer, you should be screened at age 10 years or so before the onset of your youngest family member. So, for instance, if you had a brother, first-degree relative, or a father or a mother who had colon cancer and the time of diagnosis or the time of presumed onset was at 50 years, you should start at 40 years to get screened.

ANNOUNCER: For men and women at average risk, the American Cancer Society recommends that screening begin at age 50. Routine screening test include a fecal occult blood test yearly plus a colonoscopy every 10 years. This procedure requires a clear liquid diet and laxatives the day before the test and enema the morning of the procedure.

Another option is flexible sigmoidoscopy every five years. A bowel preparation to clean out the lower colon is needed efore this procedure.

KENNETH BROWN, MD: And it's not the way it used to be, people will tell you that. "I'm not going to go through that preparation. I've heard about that gallon of stuff you gotta drink and I'm not going to do it."

Well, we have several preparations, only one of which entails drinking a gallon of liquid to basically cleanse the colon. There are tablets, there are abbreviated preparations. So they're all pretty innocuous and they all entail a day of clear liquid diet, but that's about the extent of it.

After the preparation, which is the day before, and you're cleaned, the colon is cleansed, you come in into usually an outpatient endoscopic facility where it's freestanding; it's usually not in a hospital. And, after the taking of a history, an IV is started.