Colorectal Cancer Rates Higher in African Americans, Rising in Younger People

The recent passing of Chadwick Boseman, the talented actor best known for his portrayal of the superhero Black Panther, at the age of 43 came as a surprise and shock to many. For a seemingly healthy, relatively young man to die from colorectal cancer seems almost incomprehensible.

But while colorectal cancer isn’t as common in people under the age of 50 as it is in older people, it’s not as uncommon as many people might think. In 2020, about 12% of colorectal cancers – about 18,000 cases – will be diagnosed in people under the age of 50 in the US. What’s more, while rates of colorectal cancer have been falling in older age groups in recent years, they’ve actually been rising among younger people.

Risk is higher in African Americans

Colorectal cancer also disproportionately affects the Black community, where the rates are the highest of any racial/ethnic group in the US. African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups.

The reasons for the differences are complex, but they largely reflect differences in risk factors and in health care access, both of which are related to socioeconomic status. In fact, African Americans are disproportionately burdened by cancer in general. They often experience greater obstacles to cancer prevention, detection, treatment, and survival, including systemic racial disparities that are complex and go beyond the obvious connection to cancer. These obstacles can include lower paying jobs and lack of (or less comprehensive) health insurance, lack of access to healthy and affordable foods, low-quality education and housing, and unsafe environments.

"Colorectal cancer is the second deadliest cancer in the country," said Durado Brooks, M.D. vice president of prevention and early detection at the American Cancer Society. "This disease is ravaging the Black community, and it is as important as ever that everyone has access to and is receiving the recommended screenings. Even during the coronavirus pandemic, necessary screening tests remain available to prevent the disease or find it at an early, more treatable stage."

Screening can help find – and even prevent – some colorectal cancers

Acknowledging the rising colorectal cancer rates among younger people, the American Cancer Society now recommends that people at average risk of colorectal cancer begin regular screening at age 45.

People at higher risk for colorectal cancer should talk with their doctor about whether starting screening earlier might be right for them. This includes people with:

• A family history of colorectal cancer or certain types of polyps
• A personal history of colorectal cancer or certain types of polyps
• A personal history of inflammatory bowel disease (ulcerative colitis or Crohn's disease)
• A known or suspected family history of a hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer, or HNPCC)
• A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer

Different types of tests can be used to screen for colorectal cancer. Colonoscopy is one of these, but other tests, some of which can be done at home, are also good options, especially during the pandemic.

Screening can often prevent colorectal cancer by finding and removing growths called polyps in the colon and rectum, before they have a chance to become cancer. Screening can also find colorectal cancer early, when it is still small, hasn't spread, and is likely to be easier to treat.

Know the possible symptoms of colorectal cancer

The American Cancer Society doesn’t recommend starting screening before age 45 for most people, largely because the benefits aren’t likely to outweigh the possible downsides. But it’s still important to be aware of possible symptoms of colorectal cancer, no matter what your age. The most common symptoms of colorectal cancer include:

• A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
• A feeling that you need to have a bowel movement that's not relieved by having one
• Rectal bleeding
• Blood in the stool, which might make the stool look dark brown or black
• Cramping or pain in the abdomen (belly)
• Feeling tired or weak
• Losing weight without trying

Many of these symptoms can also be caused by other conditions. But if you have any of them, especially if they last for more than a few days or are getting worse, it’s important to have them checked out by a doctor as soon as possible so the cause can be found and treated, if needed.

For more information about colorectal cancer, visit our Colorectal Cancer pages.