Five Experts to Overcome Colon Cancer Inequality

African Americans face the highest mortality rates for most cancers compared to other racial and ethnic groups, and the disparities associated with colon cancer are particularly pronounced.

African Americans are 20% more likely to develop cancer and 40% more likely to die of cancer than other groups. American Cancer Society..

Despite the impressive data, many primary care physicians are unaware of the degree of risk that colon cancer poses to African Americans. Experts say this gap needs to be addressed.

During this national colorectal cancer awareness month Becker’s We asked five experts what areas they should focus on in reducing health inequalities associated with colon cancer.

Here’s their reaction, from strengthening efforts to educate both patients and healthcare providers to spending more time navigating patients through the screening process.

Editor’s Note: Lightly edited responses for grammar and clarity are displayed in alphabetical order.

Carl Crawford, MD. Gastroenterologist at New York Presbyterian Church and Weil Cornell Medicine (New York City):

This is a complicated question as there are many factors involved here. First, we must consider the patient’s consciousness. Traditionally, there has been insufficient education surrounding colorectal cancer screening or symptoms, especially among African-American patients who are disproportionately affected by colorectal cancer. There is room for improvement when it comes to educating both patients and healthcare providers about the different types of screening tests available.

Early symptomatology recognition is another important factor. For example, bloody stools should not be shaken off as hemorrhoids. Symptomatic patients may say that their healthcare provider did not tell them to see a gastroenterologist. This is a gap that needs to be addressed and also highlights the growing need for providers to be aware of colorectal cancer disparities.

Finally, given the increasing prevalence of colorectal cancer among people under the age of 50, healthcare providers need to emphasize early screening starting at age 45.

While it’s great to have a colorectal cancer awareness month, overall, broader and more ongoing efforts are needed to increase education surrounding inequality, symptoms, and screening.

Lewis Fox Hall, Maryland. Vice President of Health Policy, The University of Texas MD Anderson Cancer Center (Houston):

Colorectal cancer, the second leading cause of cancer-related death in the United States, has long been associated with disparities among newly diagnosed individuals with death. Results have improved over time, but the gap has persisted and African Americans are more affected. Various factors, such as smoking and exposure to obesity, are associated with these inequality. Socio-economic conditions, especially insurance coverage, contribute to permanent inequality.

Great advances in reducing colon cancer mortality and morbidity can still be gained by focusing on disseminating evidence-based screening opportunities to vulnerable populations of men and women. A collaborative approach by primary care centers such as cancer centers, community health facilities, and federal-accredited healthcare centers provides proven strategies that provide navigation to screening and diagnosis and treatment, leading to narrowing, and preferably closing, inequality. I will.

Mark Friedman, MD. Gastroenterologist at Mofit Cancer Center (Tampa, Florida):

Many healthcare providers are unaware that African Americans develop colon cancer at an earlier age and have a higher mortality rate. Therefore, the first step is to increase the education of your provider and ensure that you follow the appropriate guidelines.

Many African Americans may also be unaware of the increased risk that colon cancer poses to them and their loved ones, so it is important that targeted educational tools be provided to them. Patients should be encouraged to discuss their family’s medical history so that they can know if they are at high risk.

It can be taboo among African-American patients. It should be available to anyone who wants to be screened and not at an exorbitant cost. We also need to condemn the complexity and dangers of colonoscopy and reduce the number of patients who are afraid of colonoscopy.

Filming location, MD. Gastroenterologist and Colon Cancer Screening Program Director at the City of Hope Cancer Center (Los Angeles):

It is a pity that disparities continue to exist in our basic understanding of colorectal cancer incidence, mortality, treatment, and the natural history of the disease itself. For example, some groups, such as African-American patients, showed improvements in overall incidence and mortality, but the proportion of African-Americans was higher than in other racial or ethnic groups. Is still high. We know that many ethnic minority groups are more likely to develop cancer that develops early in the later stages and that screening rates are low in these populations.

I am convinced that increasing the inclusion in consistent screening on time will reduce these disparities and lead to better results. I am a comprehensive cancer center that emphasizes a culture-centric approach to care, including multilingual instruction and consistent use of face-to-face translators in racially and ethnically diverse regions. I am practicing. As a result, we were able to comply with screening recommendations and prevent colorectal cancer in many patients. I think the emphasis should be on prevention through intensive culture-centric screening.

Dr. Mary Read Roswell Park Comprehensive Cancer Center (Buffalo, NY) Head of Cancer Screening, Survival and Mentorship:

There are certainly many things that can be done to improve the screening rate for colorectal cancer in general, especially in populations that are at particular risk or have access problems. We have two experiences. One is that there are many barriers to actually getting a screening for someone who has a family doctor and is being screened for colorectal cancer.

There are health literacy issues in terms of understanding what the role of the colon is and the effects of cancer. There are different types of tests, some based at home. With more reliable colonoscopy, patients may not be able to fully manage the stress of scheduling, taking someone in their family, boarding and taking a break from work. Despite the barriers, working with community providers can be incredibly successful in non-English speaking, African-American, and Hispanic populations if they actually help patients navigate. You can see that.

We have succeeded in bridging the gap between primary care physicians and actually screening patients. In some cases, such navigation increased complete colon screening by 20% in some of the surrounding clinics. city.

The first is a complex test. It’s not just about getting an image, and there are many misconceptions and distrusts about the health system elsewhere. Therefore, patients are often given a phone number that they will not call, even if they know they are eligible. This is not an effective way to get through this screening process, especially for patients with language barriers and health literacy barriers. More navigation is needed to complete the test. For those who don’t have a primary care physician, it’s really hard. They don’t get information and they don’t get recommendations. In many ways, taking people to the clinic and seeing a primary care physician begins at the community level.

This year was really hard. Nationally, colon cancer screening has declined in the range of about 80% to 90%, and the communities most affected by the decline in colon cancer screening are those most affected by COVID-19. This year we look forward to seeing primary care practices as people with colon cancer symptoms (pain, bloody stools, changes in bowel habits) are busy and postponing them. It means that they have not come.

In the future, colorectal cancer mortality is expected to increase by approximately 15%. So, especially now, this Awareness Month is very important for emphasizing the benefits of screening at the community level and building their navigation programs.

Other articles on oncology:
University of California, Davis Study: Risk-Based Approach Maximizes Cancer Detection When Screening Capabilities Are Limited
Mofit Cancer Center introduces needleless blood sampling
Mass.Discovered the Source of Childhood Cancer Clusters in the 1990s

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