Colorectal cancer screening should begin at age 45 for average-risk African-American men and women and be emphasized for Hispanics and Native Americans, 2 groups that have developed an increasing incidence of the disease, according to new guidelines from the American Society for Gastrointestinal Endoscopy.
The ASGE points to differences in colorectal cancer incidence and mortality rates between ethnic groups, noting that African-Americans — men in particular — have lower colorectal cancer screening rates when compared to European-Americans. That's a problem, says ASGE, because African-Americans have a higher proportion of cancers that present before age 50, and cancers found at an advanced stage during screenings account for half of the increased mortality risks in African-Americans.
In addition, the new guidelines suggest first-generation immigrants from Korea, Japan, China, Russia, and South America with a family history of gastric cancer should undergo esophagogastroduodenoscopy (EGD) screening beginning at age 40, as individuals from those countries show increased rates of gastric carcinoma.
Jason A. Dominitz, MD, MHS, FASGE, chair of the ASGE's Standards of Practice Committee, admits there's a dearth of research focused on the efficacy of changing endoscopic standards of practice based on patient ethnicity, but he says it makes sense that "increased awareness of differences in disease patterns and management among different ethnic groups could have beneficial impacts on the health-related quality of life of people in these groups."
Daniel Cook
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