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World J Gastroenterol. Jan 28, 2014; 20(4): 869-876
Published online Jan 28, 2014. doi: 10.3748/wjg.v20.i4.869
Colorectal cancer disparities: Issues, controversies and solutions
Venkata S Tammana, Adeyinka O Laiyemo
Venkata S Tammana, Adeyinka O Laiyemo, Division of Gastroenterology, Department of Medicine, Howard University College of Medicine, Washington, DC 20060, United States
Author contributions: Laiyemo AO designed the outline of the article; Tammana VS and Laiyemo AO have contributed equally in collecting the data, drafting of the manuscript and preparing the final manuscript.
Correspondence to: Adeyinka O Laiyemo, MD, MPH, Division of Gastroenterology, Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue, Washington, DC 20060, United States. adeyinka.laiyemo@howard.edu
Telephone: +1-202-8657186 Fax: +1-202-8656562
Received: October 5, 2013
Revised: November 14, 2013
Accepted: December 5, 2013
Published online: January 28, 2014
Abstract

Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the United States. There are significant differences in CRC incidence and mortality by race with the highest burden occurring among blacks. The underlying factors contributing to CRC disparities are multiple and complex. Studies have suggested that a higher prevalence of putative risk factors for CRC, limited access to healthcare services, lower utilization of healthcare resources and increased biological susceptibilities contribute to this disparity by race. This article reviews the factors associated with the disproportionally higher burden of CRC among blacks; addresses the controversies regarding the age to begin CRC screening and the screening modality to use for blacks; and proffers solutions to eliminate CRC disparity by race.

Keywords: Colorectal cancer disparities, Adenomatous polyps, Colon cancer, Colonoscopy, Screening

Core tip: This article reviews the underlying factors for the disproportionally higher burden of colorectal cancer (CRC) among blacks, addresses controversies regarding race-based screening recommendations and concludes by suggesting that a comprehensive approach that increases access and utilization of CRC screening, timely follow-up of abnormal results and treatment of CRC will be needed to reduce or eliminate CRC disparity.