Colon Cancer in the African American Population

Colon Cancer in the African American Population

The tragic passing of Chadwick Boseman at the age of 43 was shocking to many. It was difficult to imagine that a man, who was the picture of health and youth, could die from colon cancer. It has brought many questions regarding colon cancer in both the young and also in the African-American population. Unfortunately, colon cancer in the young and the African American population is not a new occurrence.

When speaking of cancers in general, African-Americans have a higher known incidence of prostate, breast, and colorectal cancer. African-Americans have the highest death rate and the shortest survival of any racial-ethnic group in the United States for most cancers. Black men also have the highest cancer incidence rate.

Colon cancer is the third most commonly diagnosed cancer in both black men and women. Colorectal cancer disproportionately affects the black community. In general, they have the highest rate of colon cancer than any racial/ethnic group in the United States. African-Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than other ethnic groups. Also, among African American patients, CRC occurs at a higher rate below the age of 50.

Modifiable risk factors for colon cancer include:

  • Excess body weight
  • Physical inactivity
  • Long-term smoking
  • High consumption of red or processed meat
  • Low calcium intake
  • Moderate to heavy alcohol consumption
  • Very-low intake of fruits and vegetables and holding fibers

Many of these risk factors disproportionately affect blacks. Black patients are also about four times more likely to be diagnosed with proximal (right-sided) tumors which, have less favorable outcomes than left-sided tumors.

The ethnic disparity seems to be, linked with biological and socioeconomic factors such as:

  • Living environment
  • Comorbidities
  • Lifestyle
  • Use and access to screening and health insurance

Based on guidelines from the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy, the current recommendations are that screening for average-risk African-Americans should start at 45 and that the screening modality of choice is a colonoscopy. Although this disease is the third cause of cancer-related deaths in the black community, it’s highly preventable. Part of the problem is compliance with colon cancer screening protocols, with screening rates among African-Americans at only 38%. Simply put, screening protocols are in place to detect and treat cancers early. Unfortunately, patients are not presenting for these procedures, and therefore detection is late, and cancers are at more advanced stages where curative options may no longer be available.

So, my key takeaway in all this is if you are an African-American at average risk and are 45, please schedule your screening colonoscopy.


Dr. Apsara Prasad, gastroenterologist for Digestive Health SpecialistsBy: Dr. Apsara Prasad

She works at our Kernersville and Winston-Salem locations.

Learn more about her here:


Digestive Health Specialists, PA is here to help if you, or someone you know, would like more information, or if you are experiencing any digestive health symptoms and would like further evaluation. Feel free to give us a call at 336-768-6211.