Colon Cancer Screening in the Black Community: When and Why You Need to Be Screened

Colon cancer has become one of the most common cancers in America. It is the third-most common cancer and the second-most common cause of deaths related to cancer. Unfortunately, African Americans are more affected by this condition than other groups. 

In the U.S., Black people have the highest colon cancer rates and more deaths related to colon cancer. Let’s look into how colon cancer affects the Black community. And let’s review colon cancer screening for African Americans: when you should get screened and how you can decrease your risk. 

Why is colon cancer more common in Black men and women?

Black men and women have a 20% greater chance of developing colon cancer. They also have a 40% higher risk of dying from it. But the exact reasons why are not clearly understood. It may be due to several factors, like a lack of access to healthcare, screening, and genetic counseling. However, this does not account for such a wide gap. 

Experts do know that Black people are typically diagnosed with colon cancer at much younger ages and at more advanced stages. But the research is ongoing as to why this happens. 

What are the risk factors for colon cancer?

When discussing risk factors for developing colon cancer, it helps to break them up into two main categories: risk factors that you can change and ones that you cannot change. 

Risk factors for colon cancer that you can change include: 

• Having a heavier body weight

• Smoking

• Eating a diet high in red meats and processed meats

• Moderate to heavy alcohol use

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Risk factors for colon cancer that you cannot change include:

• Age over 50 (colon cancer is possible at any age, but the risk is higher after age 50)

• Family history of colon cancer (parent, sibling, or child) 

• A personal history of colon polyps or colon cancer

Another known risk factor for developing colon cancer is a history of inflammatory bowel disease (IBD). These diseases, such as ulcerative colitis or Crohn’s disease, cause the colon to be inflamed over a long period of time. This prolonged inflammation increases the risk of developing colon cancer. 

What are the first signs and symptoms of colon cancer?

Symptoms will typically occur based on the location or the stage of the colon cancer. Signs and symptoms of colon cancer are commonly:

• Unexplained weight loss

• Change in stool shape

• Change in bowel habits

• Blood in stools

• Dark black stools

• Fatigue

• Anemia

• Abdominal pain

It’s possible to feel great and have no idea that colon cancer is present, especially since symptoms may not appear in early stages. That’s why early detection through screening is so important. 

How often should Black men and women be screened for colon cancer?

Colon cancer screening for Black people of average risk should start at the age of 45, according to the current guidelines. Screening will continue periodically until the age of 75. If you have a higher risk for colon cancer, screening may happen sooner. 

If you have a family history of colon cancer, you should have your screening about 10 years before the age of when your family member was diagnosed. For example, if a parent was diagnosed with colon cancer at the age of 52, you (and your siblings) should have your first screening at the age of 42.

There are several options for getting screened. The most common screening methods include: 

• Fecal occult blood test: This test can detect blood in the stool. You can have this test yearly. 

• Fecal immunochemical (FIT) test: This test is also used to detect blood in the stool. It can also be done yearly. 

• Stool-DNA (FIT-DNA): This test detects blood in stool and any abnormal DNA from a large polyp or cancer growth. You can get this test every 3 years. 

• Flexible sigmoidoscopy: This test uses a thin tube with a camera to look at the last part of the colon and rectum. You can get this test every 5 to 10 years with a yearly stool test.

• Colonoscopy: This procedure is the best test for screening and diagnosing colon cancer. It uses a longer scope to look at the entire colon and rectum. This test is offered every 5 to 10 years or more often if necessary.

As an added advantage, flexible sigmoidoscopy and colonoscopy allow your provider to remove early cancers and polyps during the procedure. Your provider will help you figure out which screening test is best for you. They’ll consider your medical history and risk factors.

How can we prevent colon cancer in the Black community?

Colon cancer is one of the most preventable cancers worldwide. The only way to prevent colon cancer is to remove colon polyps before they turn into cancer. The best way to remove polyps is to have timely screenings to ensure early detection. 

Also, knowing about your genetic risks can help you prevent colon cancer. If you have one or more family members with colon cancer, reach out to your healthcare provider. You may need to consider genetic counseling to check your risk.

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Written by:

Valerie Emuakhagbon, MD

Valerie Emuakhagbon, MD, is a board-certified colorectal surgeon. A native of Dallas, Texas, she completed the six-year BA/MD program at the University of Missouri-Kansas City.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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