Colonoscopy for colorectal cancer screening in African Americans.

Background: Studies show an increase in right-sided adenomas and cancers. In African Americans, a near equal distribution of right- and left-sided colorectal adenomas and cancers or even a predominance of right-sided adenomas and cancers has been shown. This study evaluated the location of both colorectal polyps and cancers in self-identified African Americans evaluated at Howard University Hospital.

Methods: A retrospective chart review of endoscopic records and the computerized tumor registry at Howard University Hospital for self-identified African Americans with polyps on colonoscopy and colorectal cancer diagnosed and/or treated between January 1, 1993 and December 31, 1999 was carried out. Polyps and cancers were documented as being right sided, left sided, both right and left sided, and unspecified when the location of the lesion was not documented.

Results: Eight hundred and thirty-seven patients had adenomas removed from 1993 to 1999, of which 36.3% had right-sided and 42% had left-sided adenomas. Three hundred and twenty patients were diagnosed and/or treated for colorectal cancer from 1993 to 1999, of whom 44.2% had right-sided and 46.7% had left-sided cancers.

Conclusion: Our study revealed near equal distribution of right- and left-sided colorectal adenomas and cancers in African Americans. Colonoscopy as opposed to sigmoidoscopy appears to be the appropriate modality for screening African Americans at average risk for colorectal cancer.