Despite declines in rates of new cases and deaths from colorectal cancer in African Americans, this cancer is still the third leading cause of death in this group. Death rates from colorectal cancer are about 30 percent higher in African Americans than in whites and are more than twice as high as rates in Asian/Pacific Islanders, American Indians and Hispanics.

From 1990 to 1996, the latest period for which data are available, 50 new cases of colon and rectum cancer were diagnosed each year per 100,000 African Americans in the US. That compares to 44 new cases per 100,000 white Americans, 39 new cases per 100,000 Asian/Pacific Islanders, 16 new cases per 100,000 American Indians and 29 new cases per 100,000 Hispanics in the US.

During that same period, each year there were 23 deaths from colon or rectum cancer per 100,000 in the African-American population, compared to 17 per 100,000 white Americans, 11 per 100,000 Asian/Pacific Islander, 10 per 100,000 American Indian and 10 per 100,000 Hispanics in the US.

One reason death rates from colorectal cancer are higher in African Americans is that they are not being screened for the disease as often as other populations, says Deborah Kirkland, manager of the colorectal cancer division for the ACS.

Low colorectal cancer screening rates in this population may be related to the belief of agree to have the tests, reported Electra Paskett, PhD, of Wake Forest University, at the recent ACS Science Writers Seminar. Dr. Paskett recently completed a study of colorectal cancer screening among low-income African-American women.

The main reason the Wake Forest team says many low-income, African-American women do not have a common colorectal screening exam called a flexible sigmoidoscopy is their doctors don't recommend the exam. Doctors also have preconceived notions about cost barriers.

"Colorectal cancer is a preventable disease through detection of precancerous polyps, better diet and a generally healthier lifestyle," Kirkland says. Colorectal polyps, the growths that may be precursors to colorectal cancer, generally do not become cancerous for about a decade. On average, "one in seven polyps develops into cancer," Kirkland says. The sooner those polyps are removed, the less chance an individual will develop cancer.

When it is detected at an early, localized stage, the survival rate for colorectal cancer in African Americans is 84 percent. Kirkland is hopeful that with increased awareness about screening and risk factors, colorectal cancer will diminish in all populations.

The ACS recommends that, beginning at age 50, both men and women should follow one of the three screening options below:

• Yearly fecal occult blood test plus flexible sigmoidoscopy every 5 years, or
• Colonoscopy every 10 years, or
• Double contrast barium enema every 5 to 10 years.

A digital rectal examination should be performed at the time of each screening sigmoidoscopy, colonoscopy or barium enema examination.

A number of lifestyle changes can lower one?s risk of colorectal cancer. These include choosing most foods from plant sources, including five servings of vegetables and fruits daily, avoiding high-fat foods, using alcohol moderately, if at all, and not using tobacco products.

The ACS advises people to know their risk factors. People with inflammatory bowel disease or with family histories of colorectal cancer are at an increased risk of developing colorectal cancer.