Colorectal cancer doesn’t discriminate
OPINION - African-Americans are less likely to receive CRC screenings, especially if they are uninsured...
Academy Award and Golden Globe nominated actor and musician Terrence Howard is one of many who should be commended. Not only because of his talents on the big screen, but because of his efforts to raise awareness about the second leading cause of cancer-related deaths among men and women in the United States- colorectal cancer (CRC).
Howard lost his mother to this dreaded disease in September of 2008 and has become a spokesperson for the Centers for Disease Control and Prevention Screen for Life: National Colorectal Cancer Action Campaign. Preceded only by lung cancer as a major cause death in this country, cancer of the colon and rectum (CRC) knows no gender or status.
This is evident in the untimely deaths of both Eartha Kitt and Teddy Pendergrass. Additionally, former Major League Baseball players Darryl Strawberry and Eric Davis have both required surgery to battle this disease. Although the focus of this disease is spearheaded by some noteworthy people, it is a cancer that has affected many. In 2005, the CDC estimated that over 140,000 people were diagnosed with CRC and approximately 53,000 died from the disease. Screening rates for CRC in the age range of 50 to 64 increased from twenty-five percent in 1997 to 55 percent in 2008; however, the rates still fall below those for cervical and breast cancer.
March is National Colorectal Cancer Awareness Month and the numbers of those affected highlight the importance of raising awareness and getting preventative screening for CRC. It is not a disease that hails from some exotic lands but is one that is detectable, treatable and in many cases preventable. Most notable, it targets men and women over the age of 50 approximately 90 percent of the time – that means our fathers and mothers and those close to us are the ones most vulnerable. Although the number of physicians that screen their patients for this disease has increased, there is still a great disparity in who is getting screened.
The discrepancy in the numbers was further highlighted in February at a thirteen member National Institutes of Health (NIH) panel which met in Bethesda Maryland at the State of the Science Conference. During this conference, the main topics of discussion were CRC, screening rates, and the gap that exist among Americans who were able to survive this cancer. Unfortunately, there were no surprises-screening rates for CRC while on the rise, still presented a disproportionate rate among those without health insurance and minorities. African-Americans and Hispanics still fall short and are less likely to receive CRC screening, especially if they are uninsured. More affordable access to health care will serve to save so many lives. Not just from CRC but from other opportunistic diseases that can be identified simply by regular visits with a physician.
There are several risk factors for this disease: a strong family history of colon or rectal cancer or colon polyps, a personal history of colon or rectal cancer or history of inflammatory bowel disorders like Crohn’s disease or ulcerative colitis, and being physically inactive. Diet and certain behaviors also seem to increase our risk. Red meat, other processed meats like cold cuts, bacon, sausage, and hot dogs, obesity and cigarette smoking are all risk factors. An article published in the Journal of the American Medical Association in January 2005 stated that individuals who ate the most red meat were thirty to forty percent more likely to develop colon cancer than those who ate less. Although a diet with less red meat is not one commonly found in the African American community, small changes in diet could continue to enhance and lengthen ones quality of life.
We have heard since we were in high school biology that the intestines were miles long. How that length is able dwell inside of us is a mystery to many, but the symptoms for CRC should not be part of the mystery. Common symptoms of CRC include a change in bowel habits that last for more than a few days like constipation or diarrhea; gross rectal bleeding or blood in the stool; cramping abdominal pain, fatigue, night sweats, and weight loss. If you or someone you know has these signs and symptoms, they must see a doctor immediately. While these signs and symptoms could represent other disorders, it is important to seek consultation from a professional rather than ignore them. Depending on your physician, one of three screening options will be done: fecal occult blood test plus a flexible sigmoidoscopy every five years; colonoscopy every ten years, or a double contrast barium enema every five to ten years. If you have a strong family history of CRC or polyps, a personal history of CRC or polyps, or a history of long standing inflammatory bowel disease, your physician may recommend screening earlier.
At the conclusion of the NIH’s State-of-The-Health-Science Conference, several solutions were proposed to increase screening for CRC and to reduce barriers to screening. These recommendations included: elimination of financial barriers to screening and follow up; including patient reminder systems and one on one interactions with health professionals or educators; conducting research to assess the effectiveness of tailoring programs to certain populations; implementation of systems to ensure appropriate follow-up of positive screening results; developing systems to assure high quality screening programs; and finally conducting studies to determine the effectiveness of the available screening methods in usual practice settings. All of these suggestions can be implemented and would continue to save lives, but until these suggestions become best practices via legislative endorsement in the health care reform bill and/or endorsement by the medical community, it is important that you take control of your own health.
It is imperative that you know your numbers and your personal and family history so that you are able to make sound decisions about your health. Early screening, although essential, is only one part of reducing our risk. A diet high in fiber-rich foods like fruits and vegetables and low in fats, red meat, and processed meat coupled with regular exercise not only reduces our risk of CRC, but of our nation’s number one killer heart disease. Remember, awareness of the disorder and early detection is key to a aggressive treatment and/or a cure.
For more information on CRC visit the CDC’s web site at www.cdc.gov/cancer/colorectal/index.htm>
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