Abstract PC01-02: Colorectal cancer screening for African Americans: Should we be screening at an earlier age? Con

Abstract

Abstract African Americans have the highest colorectal cancer (CRC) incidence and mortality of any racial/ethnic group. Citing the higher age-specific rate of CRC compared to whites that begins after age 45, several medical societies have recommended early age of screening initiation for African Americans at age 40 or 45 years. However, there are several reasons why early screening initiation may be a suboptimal strategy for improving CRC outcomes among African Americans. First, evidence to support effectiveness of early screening initiation for improving CRC outcomes is limited. The highest excess rates of CRC among African Americans occur after age 60, and the most rigorous studies suggest that there are not substantial differences in rates of polyps between African Americans and other groups younger than age 50, making the effectiveness of early initiation uncertain. Second, there are substantial logistical challenges to implementing early age of screening initiation for African Americans, but not other groups. Third, many alternate strategies have been proven to improve CRC screening; if implemented widely these strategies might be more effective than lowering the age of screening initiation. In taking the “Con” position against lowering the screening age, the author will highlight these issues, and make the case that lowering the screening age may not be the optimal strategy for improving CRC outcomes among African Americans. Citation Format: Samir Gupta. Colorectal cancer screening for African Americans: Should we be screening at an earlier age? Con. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr PC01-02. doi:10.1158/1538-7755.DISP13-PC01-02