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Ashkenazi Jews and Colon Cancer

TO THE EDITOR: Of the nearly 6 million Jews in the United States, the overwhelming majority are of Ashkenazi descent. Ashkenazi is the Hebrew term for German. These Jews originated in Israel and migrated to parts of Europe starting before the 9th century (1). An APC mutation is found in 6.1% of American Jews (APCI1307K) (2) and in 28% of Ashkenazi Jews with a family history of colorectal cancer (CR) (3). Given the increased incidence of inflammatory bowel disease in the Jewish population as well, it can be confidently asserted that the average Ashkenazi Jew in America is at a higher than average risk for CRC. As such, it would seem advisable for physicians to identify patients who are of Ashkenazi Jewish ethnicity and approach a screening strategy for CRC that is appropriate for an individual at moderate risk. This would include an initial screening colonoscopy for complete colon evaluation starting at least by age 50 yr.