African-Americans who are diagnosed with colorectal cancer at a young age have significantly worse survival rates than young white patients, according to the National Cancer Institute in Bethesda, Maryland.
The disparity was found even among those who were diagnosed with early-stage disease, said Dr. Elena Stoffel of the University of Michigan Comprehensive Cancer Center, who along with her colleagues published their findings last year in the Journal of Clinical Oncology.
March kicks off National Colorectal Cancer Awareness Month, bringing into the spotlight the fourth-most common cancer in the United States and the second-most deadliest cancer.
Colorectal cancer affects people in all racial and ethnic groups and is most often found in people 50 and older.
But African-American men and women have a higher risk of developing colon cancer and a lower survival rate – about 20 percent higher incidence rate and 45 percent higher mortality rate – compared to Caucasians, Asians, Hispanics and Native Americans, partly because of disproportionate screening.
The good news? If everyone 50 and older were screened regularly, six out of 10 deaths from colorectal cancer could be prevented, health officials said.
Communities, health professionals and families can work together to encourage people to get screened.
“So here’s the bad news: African-Americans have the highest risk of developing and dying from colorectal cancer,” said Dr. Cedrek McFadden, a clinical assistant professor of surgery at the University of South Carolina School of Medicine Greenville.
“African-Americans also have a higher stage of disease at presentation and a stigma that this disease is a disease of older white men exists along with deep-seated mistrust of physicians, which causes many African-Americans to ignore preventive strategies,” said McFadden, a double board-certified colorectal surgeon with the Greenville Health System.
The good news is that colorectal cancer is preventable and potentially curable if found early, cancer experts said. While screenings using a colonoscopy usually begins at age 50, there has been discussion on whether African-Americans should begin the process at 45, McFadden said.
To help fight and prevent the disease, many said black men and women certainly should have a screening at no later than 50 but they should also pay close attention to any symptoms including — but not limited to — bleeding, changes in bowel habits, abdominal pain and unexplained weight loss.
“African-Americans need to reduce fat intake from animal sources such as pork, beef and even chicken,” said Dr. Carolyn Dean, a nutrition and diet expert and author of “Hormone Balance” and “The Magnesium Miracle.” “Studies have shown that a diet high in animal fats increase the risk of intestinal polyps along with colon cancer. Whereas a diet high in fatty fish and healthy fats from nuts and oils was shown to prevent polyps and lower the risk of colon cancer.”
Fitness trainer Carol Michaels, who has worked as a cancer exercise trainer for more than two decades including at Newark’s Beth Israel Medical Center with mostly African-Americans, said many patients aren’t told to have a timely colonoscopy.
“They were not told that they need to have one at an earlier age if there is a family history and perhaps every five years without a family history,” Michaels said. “The medical community and health organizations need to do a better job in education and awareness of the importance of the colonoscopy. A good place to start would be the church and in schools.”
The Colon Cancer Alliance has a plenty of information about screening issues within the African-American community, and its founder and CEO, Michael Sapienza, is often called upon to talk about the stigma issues facing minorities.
Sapienza lost his mother to the disease and he’s fought to bring awareness ever since.
“As someone personally that has dealt with the stigma in talking about the disease in my African-American family, it comes down to a culture who are not comfortable in talking about their bodies or raise when they are sick,” Sapienza said. “It’s the feeling they don’t want family members to worry about them. I dealt with this a lot personally. In working in this arena for eight years with the Colon Cancer Alliance, I hear the same reasons over and over again particularly with folks in minority communities. I even had a person freak out when I asked them if they have had a colonoscopy at a health fair, as if I just offended them.
“We need to get to a place as a society to be comfortable in talking about our backside, like we are about our breast with breast cancer,” he said.
So what should African-Americans be doing as the nation observes Colorectal Cancer Awareness Month? Here’s what experts say:
• Push to have conversations with your family about family history. If colon cancer runs in your family and you are aware of it, it can save a life.
• African-Americans should get screened at age 45 instead of 50, due to the higher incident rate.
For more information, visit www.ccalliance.org.