Changes in the situation of Chadwick Bozeman and people with colorectal cancer

This article has been reproduced with permission of STAT. First edition August 31, 2020 here..

People all over the country mourn the death of actor Chadwick Bozeman, who died of colon cancer at the age of 43.

Marvel’s “Black Panther” Bozeman best-known actor in the role of T’Challa’s title Died on Jackie Robinson’s day of the yearCelebrating the Legendary Black Baseball Player The drawn Bozeman In a 2013 movie.

Bozeman kept his fight against colon cancer secret. Several of his films, including “The Black Panther,” were filmed after being diagnosed with stage 3 colon cancer in 2016.

Shocking Bozeman’s death reflects the increased incidence of colorectal cancer in young adults. One of us (YDC) knew that blacks had too much colon cancer. Tyrone GaleWas a politician’s aide who died in 2018 and worked for Hillary Clinton and Kamala Harris, and was also the brother of a close friend. It was devastating to know that he was diagnosed with colon cancer. Even young doctors are often surprised when young men die at the age of 30 because they are often considered ill in the elderly.

read more: Learned the difficult way colon cancer is increasing among young people

Bozeman’s death fuels the debate about the increased incidence of colorectal cancer, including in adolescents under the age of 50, and racial inequality and morbidity in screening for colorectal cancer.

Many doctors on Twitter this weekend education about Screening guidelines And that Different effects of colon cancer on Black community compared to white community..

The facts are: Colorectal cancer is the third most common cancer in men and women (excluding skin cancer). In the last decade, the proportion of new colorectal cancer cases has More young people, But still relatively uncommon in this age group. so American Cancer Society From the 1980s to at least 2013, a new diagnosis rate for colon cancer increased by 1% to 2% each year in a study of adults aged 20-39. More notably, the incidence of rectal cancer has increased by 3% each year. Adults of this age group at the same time. Result is 1 in 5 colorectal cancer cases I am currently between the ages of 20 and 54.

The cause of this rise is unknown. It may be due to improved screening of high-risk individuals, such as those with a family history of colorectal cancer or those with an inherited genetic mutation, the latter accounting for 5% of cases. However, this is not a complete explanation of the increase. People under 55 58% more likely to be diagnosed In late stage colorectal cancer, symptoms may include changes in bowel habits, rectal bleeding, unintended weight loss, or fatigue.

The chance of survival of colorectal cancer depends largely on the time it is diagnosed. If detected early, Up to 90% Survive for more than 5 years for an individual. However, if found at a higher stage, the 5-year survival rate will be as low as 14% in all races. This is especially worrisome for black men who are more likely to be diagnosed With advanced illness: Only 9% can survive more than 5 years after diagnosis.

Non-Hispanic black individuals have the highest incidence and mortality of colorectal cancer of all racial groups in the United States. Black americans Relative 5-year survival rate of 58.1%On the other hand, the survival rate of white Americans is 64.2%. The reason for the gap is not fully understood, but is believed to be due, at least in part, to the lack of research on ethnic minority health. National Institutes of Health One of the most important issues Facing the US healthcare system. But some (probably many) members of the scientific communityNot accepting messages.. “

Factors contributing to the inadequate screening of blacks for colorectal cancer may be variability across different screening guidelines. The racial and ethnic variations in the guidelines are not unique to colon cancer. For example, body mass index recommendations for Asians are different from recommendations for other races, as are Ashkenazi Jewish breast cancer screenings. This variability, while adequate, complicates care.

read more: Seeing a “deep pocket” effect when insurance companies pay for healthcare

Moreover, inconsistencies between organizations are exacerbated. For example, until last year, both the Preventive Services Task Force and the American Cancer Society recommended starting colorectal screening at age 50 for all average-risk individuals, regardless of race. In contrast, the American Academy of Gastroenterology has recommended that blacks begin screening for colorectal cancer for several years. 45 years oldWhile the American Medical Association advises that screening of black men and women begins 40 years old..

There is compelling evidence that both doctors and patients are unaware of the difference Recommendations for blacksWill result in improper screening.

But in 2018, the American Cancer Society Shift that recommendation To start the screening 45 years of age at all average risk individuals.. The guidelines from the US Preventive Services Task Force haven’t changed, but we hope updates from the American Cancer Society will lead to early screening of blacks.

Between updated guidelines and innovative programs born from new research Patient Navigator Program Using Black Barbershop In order to join the community, we hope that the black community will have improved screening for colon cancer leading to early detection and reduced mortality.

In the case of Bozeman, who was diagnosed at age 39 and was able to access world-class care to celebrities, it is unclear whether his race affected his outcome. We are unaware of his personal risk factors, family history, or early symptoms of his cancer. Yet his death creates the opportunity to seek better research, better screening, and better outcomes for colon cancer-a must.

Inadequate knowledge of colon cancer symptoms in young people, especially in the black community, needs to be addressed to improve awareness of screening guidelines among these individuals and their health care providers. Without such behavior, incidents like Bozeman’s disease and Gail’s disease will continue to occur. They may become more commonplace.

Lydia A. Flier is a Physician at Mount Auburn Hospital in Cambridge, Massachusetts and a Medical Lecturer at Harvard Medical School. Gabriella Rico is an undergraduate student and a member of the Harvard Medical School Outreach Program. Yamicia D. Connor is an OB-GYN and a Fed Fellow of the Minority Health Policy at Harvard TH Chan Public Health School. Connor and Flier are two co-founders. The race for better health, An organization that aims to reduce the gap in medical care through the formation of a coalition of experts.