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Today’s blog post comes from guest contributor Duane Ross, M.D. Dr. Ross is a member of the New Mexico Black Leadership Council’s Physical Health subcommittee, and he is passionate about the committee’s goal to increase knowledge about the health concerns affecting the African American community. The focus area of this piece is colorectal cancer, otherwise known as colon cancer. The recent death of Chadwick Boseman makes raising awareness of colon cancer prevention more timely than ever. Read on to learn the important facts about colon cancer, how it affects members of the Black community, and the most effective methods of colon cancer prevention and treatment.
Colon cancer kills African Americans at a higher rate than other racial groups in the U.S. Here’s what you need to know.
By Duane Ross, M.D.
Like many, I was saddened to hear that Chadwick Boseman, a rising talent with so much left undone, had died. Another Black life gone too soon, not from violence or drugs, but another cruel inequity. Colon cancer, which took him from us, affects African Americans at a rate 20% higher than other racial groups in this country and kills us at a rate 40% higher. To be clear, African Americans have worse outcomes from many health issues, from hypertension to stroke to diabetes. While it is true that Blacks in this country often do not have the same access to healthcare as others it is also true that the care we do receive is often lower in quality. But much remains in our control if we know what to do.
There are risk factors for colon cancer that we cannot change and risk factors we can. We cannot do anything about getting older, our family history, or our race; but there are so many other risk factors that we can modify. Risk factors that can be changed include smoking, being overweight, not being physically active, and having a diet high in red and processed meats. Changing these risk factors may not be easy, but they are within our control and any progress in those areas may reduce our risk of developing colon cancer. But doing all the right things does not mean you have eliminated any chance of getting colon cancer; that is why screening is so important.
Colon cancer usually starts out as a polyp (like a fleshy bump) in the lining of the large intestine. At this stage, there are typically no symptoms; the polyp is not big enough to be an obstruction and it usually does not bleed enough to be obvious. Over time (10 to 15 years), the polyp continues to change and grow until it becomes an actual cancer. At this stage, there may be symptoms such as a change in the stool, blood, weight loss, fatigue, even pain. The cancer may also have spread to other parts of the body. The chances for survival are greatest when doctors can find polyps through screening and remove them before they become cancer. In fact, the rate of colon cancer in people 55 years of age and older has declined largely due to screening. It is an uncomfortable topic, but colon cancer screening saves lives.
So, how do we screen for colon cancer? There are more options than ever before; but each one has its pros and cons.
Colonoscopy is the gold standard for colon cancer screening. It is the only option that allows for removal of any polyps at the same time as the screening. If no polyps are found during your colonoscopy, you do not have to have another one for ten years. Unfortunately, this test requires a couple of days of preparation and the procedure involves anesthesia; you will need to be driven home afterwards and this will mean a day out of work.
There are other tests that look for blood or other markers of cancer in the stool and some of these can even be done at home and mailed to the lab. These tests do not require any preparation and you can continue normal activities before and after the test. If these tests are normal you will need to repeat them every 3 to 5 years (depending on which test you choose). If any of these tests comes back positive, you will still need a colonoscopy since that is the only way to remove any polyps that might be there.
As we continue to work towards progress in the areas of justice reform, poverty, education, drugs, we must not neglect our health. With so many outside forces seemingly stacked against us, it is important that we take control wherever we can. Modify your risk factors, talk to your doctor about choosing a test that is right for you, and get screened.
Colon Cancer: What You Need to Know
- Excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women
- Also third leading cause of cancer death
- Rates have dropped in people 55 years of age or older due to screening
- Rates have risen in people younger than 55
- Risk factors you can change
- Being overweight
- Not being physically active
- A diet high in red meats and processed meats
- Smoking
- Moderate to heavy alcohol intake
- Risk factors you cannot change
- Age
- Family history of polyps or cancer
- Personal history of polyps or cancer
- Inflammatory bowel disease
- Having an inherited syndrome
- Type 2 diabetes
- Your race
- African Americans have the highest incidence (20% higher chance of developing) and mortality (40% more likely to die) of all racial groups in the US
Prevention – it takes a polyp 10 to 15 years to develop into cancer. Removing polyps can prevent progression to cancer. Screening may also catch cancer early when it can be treated more successfully.
About the Author
Dr. Duane Ross a New Mexico resident originally from East Harlem in New York City. He received his undergraduate degree in English Literature at Cornell University and his medical degree from Howard University College of Medicine. He practiced primary care, urgent care, and hospitalist care for several years before switching to an administrative role with Managed Medicaid. He is retired as the Medical Director at True Health New Mexico. He has served on the boards of Bosque School, the American Lung Association of NM, and Oasis. He is on the Physical Health subcommittee for the New Mexico Black Leadership Council.
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