Screening uptake may contribute to higher risk of colon cancer for black people

Black people have a higher risk of colorectal cancer than white people, but this risk is likely not due to genetics. Data from a recent study by researchers from the U.S. Department of Veterans Affairs, Regenstrief Institute and Indiana University School of Medicine adds more data to the existing evidence.

"The next step is determining what is behind this increased risk," said lead author Thomas Imperiale, M.D., Regenstrief Institute research scientist, VA investigator and professor of gastroenterology and hepatology at IU School of Medicine. "Lifestyle and healthcare-related behaviors may explain some of the difference."

In the study, the research team looked at more than 90,000 veterans who underwent a colonoscopy at 18 VA facilities during a seven-year period. In the overall study population, Black veterans had a higher risk of colorectal cancer. However, in a subgroup of people who got routine screenings, the risk was equal for Black patients and white patients, which suggests that the difference is not biological.

"It could be that Black patients are not getting screened, as suggested by guidelines, or that they respond to early symptoms differently, perhaps delaying seeking treatment for symptoms of colorectal cancer longer than white patients do," said Dr. Imperiale. "Screening is one of the most powerful tools for preventing or detecting colorectal cancer early, when it is curable."

Regenstrief Research Scientist NiCole Keith, Ph.D., who was not involved in this project, studies health disparities.

"Often, Black patients do not have access to screening or the ability to attend an appointment. Historically, this population has also had trust issues with healthcare, all of which could contribute to these disparities," said Dr. Keith. "We need to develop a way to make these important tests more accessible to everyone and improve trust in healthcare."

The study also found that the risk of colorectal cancer increases for all patients with age.