Colorectal Cancer Risk Factors: Understanding the Racial Divide

Colorectal cancer is one of the most preventable cancers, yet it remains the second leading cause of cancer death in the United States. What makes this even more concerning is that the burden of the disease is not the same for everyone. Research shows clear differences in colorectal cancer risk factors and survival rates depending on race.

African Americans face the highest risk, with both increased incidence and mortality compared to other groups. These disparities raise important questions: Why do outcomes differ by race? And how can we close the gap?

This guide looks at colorectal cancer by race, the factors that contribute to inequities, and how access to screening and care can save lives.

At a Glance 

• African Americans are at higher risk of developing and dying from colorectal cancer.
• Barriers such as limited screening, delayed diagnosis, and unequal access to care contribute to disparities.
• Lifestyle, genetics, and social determinants of health all play a role in who gets colorectal cancer.
• Regular screenings and early intervention significantly improve survival rates.

Colorectal Cancer Risk Factors by Race

Colorectal cancer affects people of all races, but data shows significant differences in how it impacts each group.

Higher Risk Among African Americans

• Earlier Onset: African Americans are more likely to be diagnosed before age 50.
  
• Higher Mortality: According to the American Cancer Society, death rates are almost 40% higher among African Americans compared to white individuals.
• Advanced Stage at Diagnosis: Cancers are often discovered at later stages, which makes treatment harder and survival rates lower.

Other At-Risk Populations

Native American, Hispanic, and Asian populations also experience disparities, though the reasons vary. A mix of genetics, environment, and access to preventive care shapes the increased risk

Why Do Racial Disparities Exist?

The causes are complex and interconnected.

Access to Care

One of the biggest barriers is access to healthcare. People in underserved communities often face:

• Limited or no insurance coverage.
• Fewer local providers, especially specialists.
• Longer wait times for diagnostic testing.

Screening Disparities

Colorectal cancer can often be prevented or caught early with regular screenings. But African Americans and other minority groups are screened at lower rates than white communities. Without screenings, cancers go undetected until symptoms appear, which usually means the disease is more advanced.

Lifestyle and Environmental Factors

Diet, obesity, smoking, and physical inactivity increase colorectal cancer risk. Many communities of color face additional challenges, such as food deserts, income inequality, and fewer safe spaces for exercise. These social factors create higher risks that go beyond personal choices.

Genetic Differences

Some studies suggest genetic variations may play a role in higher risk among African Americans. While biology can influence risk, genetics alone do not explain the survival gap. Environmental and systemic factors weigh heavily in the disparity.

Closing the Gap: Screening and Prevention

The most effective way to reduce disparities is through prevention and early detection.

Screening Recommendations

• Start Earlier: The American Cancer Society recommends screening at age 45 for adults at average risk. Some experts advise African Americans to begin even earlier due to a higher risk.
  
• Know Your Options: Colonoscopies are the gold standard, but stool-based tests (like FIT or Cologuard) are also available.
• Stay Consistent: Regular screenings over time are what provide the most protection.

The Role of Education and Awareness

Many people delay screenings simply because they aren’t aware of their risk or don’t know their options. Conversations and awareness campaigns can change that.

Steps You Can Take Now

• Talk with your family about health history.
• Ask your primary care provider about the right time to start screening.Encourage friends and loved ones to keep up with screenings.
• Encourage friends and loved ones to keep up with screenings.

Normalizing these conversations can save lives. The more people talk about it, the less stigma and fear surround colorectal cancer and prevention. 

FAQ: Colorectal Cancer Disparities

Who gets colorectal cancer?
It can affect anyone, but African Americans face the highest rates of diagnosis and death in the U.S.

Why are African Americans at higher risk?
Factors include fewer screenings, reduced access to care, higher rates of obesity and other risk factors, and possible genetic differences.

Can colorectal cancer be prevented?
Yes. Regular screenings, eating a balanced diet, staying active, and avoiding smoking and heavy alcohol use all lower the risk. Early detection is key to better outcomes.

Moving Forward for a Healthier Future

Racial disparities in colorectal cancer are preventable. By expanding access to care, improving education, and encouraging screenings, we can reduce risk and improve survival rates. Every step toward earlier detection makes a difference.

Schedule a Screening in Birmingham

Colorectal cancer is far easier to treat when caught early. At the Alabama Colon & Rectal Institute in Birmingham, our specialists provide advanced screenings and compassionate care to help protect your health. Don’t wait—schedule your screening today and take control of your colorectal health.

Schedule a Colonoscopy with Our Birmingham Specialists

Colorectal cancer is preventable when detected early, but delaying care can increase risks, especially for those in higher-risk groups. At the Alabama Colon & Rectal Institute in Birmingham, our experienced team is here to provide compassionate care, advanced screenings, and personalized treatment. Schedule your appointment today and take an important step toward protecting your health.