November 6, 2023 – Black Americans are disproportionately affected by colorectal cancer, and access to treatment for this highly preventable disease is believed to be the explanation this group is falling in poor health 20% more likely received one Colon cancer diagnosis than another racial or ethnic group.
Black Americans are about 40% more more likely to die from the disease than most other patient groups. A Recent study also found that 26% of Black Americans are diagnosed with colorectal cancer that has already metastasized, meaning the cancer has spread to other places within the body.
“The influence of social determinants of health on the diagnosis and treatment of colorectal cancer is clear to me as a practitioner [cancer doctor] and person of color,” said Jason Willis, MD, PhD, a clinical researcher within the departments of gastrointestinal medical oncology and genomic medicine on the University of Texas MD Anderson Cancer Center at Houston. “At a systemic level, we know that disparities in access to health care disproportionately impact many racial and ethnic minority groups. This is particularly important when it comes to access to screening and routine screening for common cancers such as colorectal cancer.”
The problem often exists in entire districts or cities.
“This may be due to lack of access to primary care, inadequate referrals for screening, cultural barriers and/or community-level factors,” Willis said. “There is also evidence that some of the differences in CRC risk observed between different racial/ethnic communities may also be due to differences in the prevalence of underlying risk factors such as tobacco use and type 2 diabetes.”
Black patients also can face information barriers to early CRC screening, he said Christina M. Annunziata, MD, PhDSenior Vice President for Extramural Discovery Science on the American Cancer Society.
Other barriers could include fear of the invasiveness of a colonoscopy, a lack of expertise of the advantages of screening and a lack of expertise of what role the disease plays in family history, Annunziata said. “These apply to the entire U.S. population and are amplified in black patients.”
Then there are disparities in treatment, which can stem from a scarcity of access to health care, including insurance coverage, transportation difficulties and the time required for treatments reminiscent of surgery, radiation and chemotherapy, she said. “In addition, Black patients diagnosed with advanced cancer require more intensive, expensive and time-consuming treatment regimens that may be unattainable due to social and economic barriers,” she said.
Are there biological explanation why black persons are at higher risk for colon cancer?
Most likely no. When black patients received high-quality colonoscopies, there was no difference within the variety of precancerous CRC polyps or CRC tumors in comparison with white patients tested with the identical equipment, it says Data from Memorial Sloan Kettering Cancer Center. This further demonstrates the importance of black patients being screened for the disease early and effectively.
But genetics could also be one reason colorectal cancer could be difficult to treat in black patients. Additionally Research of Memorial Sloan Kettering found that colorectal cancer patients of African descent could have tumors to which they don't respond well Immunotherapy And targeted cancer therapy.
The researchers found that these patients' tumors were less more likely to have the molecular profiles needed for these treatments to be effective.
However, further research is required. Currently, researchers have little or no evidence as to why, when and the way these molecular and biological differences in CRC exist between different racial/ethnic backgrounds and ancestries, he said.
Black patients are also more commonly affected diagnosed under 50 years in addition to. Researchers don't yet know exactly why that is, but consider that poor food regimen, unhealthy bacteria within the gut and inflammation could contribute to the cause. (Eating a healthy food regimen and exercising more can reduce an individual's risk.)
What are the symptoms of colon cancer?
Intestinal polyps, that are growths that may result in colon cancer, and colon cancer itself can haven't any symptoms. If an individual has symptoms, they could include:
- Changes in bowel habits
- Blood in stool
- Diarrhea
- constipation
- The feeling that bowel movements are usually not complete
- Persistent abdominal pain, stomach pain, or cramps
- Weight loss with none explanation
Any or all of those symptoms warrant a visit to the doctor. These symptoms are the identical for all racial and ethnic groups. Since colon cancer symptoms are usually not at all times obvious, screening is much more vital.
What can Black patients do to cut back their risk of developing colorectal cancer?
There are plenty of solutions that patients can pursue on their very own.
Learn more about CRC online
The premature death of the Oscar-nominated actor Chadwick Boseman The undeniable fact that they developed colon cancer at age 43 greatly increased awareness of the disease, particularly amongst black Americans. A study from the University of British Columbia and Simon Fraser University's Beedie School of Business found that within the months following Boseman's death in August 2020, there was a spike in web searches about colorectal cancer, particularly in areas where many Black Americans live. The study authors emphasized the importance of public health leaders discussing Boseman's diagnosis with their Black patients in order that they not only change into inspired by his courageous fight against the disease, but additionally proactively advocate for themselves Get tested for colon cancer.
Reading Boseman's journey is a crucial begin to patient education. It can be vital to learn something in regards to the disease itself and the way colon cancer prevention actually works. Then writing down inquiries to ask the doctor before screening is an important approach to feel empowered and understand what certain test results mean.
Be proactive
Find out about family history.
“It is difficult to determine the best age for screening if the patient does not know their family history,” Annunziata said. It's helpful to ask older relations if colon cancer has affected previous generations.
If there's a robust family history, a patient will likely must be evaluated earlier.
“[Doctors] should explain the benefits of colorectal cancer screening with colonoscopy starting at age 45 in the general population, or earlier if the person has a family history of colorectal cancer,” Annunziata said. If a patient's doctor doesn't provide this information prematurely, asking for the exam directly is certainly the appropriate step.
If a Black patient is diagnosed with colon cancer, they need to find out about critical follow-up care after diagnosis. Physicians also needs to be more proactive in enrolling patients in vital clinical trials. According to the addition Data According to the American Cancer Society, only 7% of patients participating within the FDA's cancer drug clinical trials are Black. Physicians also needs to be more proactive in enrolling patients in these and other vital clinical trials; It is entirely appropriate for a patient to go looking for studies themselves and likewise share them with their doctor.
And keeping all appointments and completing chemo or radiation treatment is critical.
“For patients undergoing treatment, physicians can ensure that patients understand the importance of receiving the full course of recommended treatment and that they receive the support to tolerate expected side effects,” Annunziata said.
Aim for reassurance
Patients diagnosed with colorectal cancer have quite a few resources for emotional support. The American Cancer Society offers Support for all physical and psychological elements of cancer 24 hours a day. The Colorectal Cancer Alliance also offers comprehensive resource guides.
Support groups at local hospitals or communities may also be extremely helpful.
Read the stories of Black patients who're survive And thrives Despite a colon cancer diagnosis, it could possibly even be incredibly inspiring.
It can be very vital for Black patients to inform their doctors once they are usually not receiving the support they need. A physician might help by brokering additional help inside a patient's community – an approach that really breaks down barriers to colon cancer treatment.
“What is very encouraging is that through targeted interventions and outreach, there have been significant improvements in CRC screening rates and early detection in Black communities,” Willis said. “In this way, all physicians can play an important role on a broad and systemic level by advocating for and implementing interventions in their communities.”