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Chadwick Boseman’s death brings a reminder: Black colon cancer risk is high

African Americans have the highest rates of colorectal cancer of any racial/ethnic group in the U.S. And the number of patients under 50 is rising.

The call came Monday after a weekend of public mourning over the news that actor Chadwick Boseman had died of colon cancer.

The man was on his way to the gym. Like Boseman, he was Black, around 40 years old. He made an appointment for a colon cancer screening in the Brandon office of Dr. Bhavtosh Dedania.

Onscreen, Boseman’s portrayal of the first African superhero in Marvel’s Black Panther empowered Black moviegoers and inspired Black youth, who saw themselves in his character. In the days since his death, that connection is taking an entirely different form, with some starting to gauge their own risk for colon cancer.

African Americans have the highest rates of colorectal cancer — which includes colon and/or rectal cancer — of any racial/ethnic group in the United States, according to the American Cancer Society. From 2012 to 2016, incidence rates of colorectal cancer were about 20 percent higher among Blacks than for non-Hispanic whites. Death rates were nearly 40 percent higher.

In Florida, rates of colorectal cancer deaths are similarly disproportionate across racial/ethnic groups. From 2013 to 2017, according to the Centers for Disease Control and Prevention, the rate was 16.3 per 100,000 within the Black community. For non-Hispanic whites, it was 12.8 per 100,000.

The gap widens when looking solely at men.

Black men are more likely to be diagnosed with colon cancer and more likely to die from it than any other group, followed by Black females, said Clement Gwede, who researches cancer disparities as a senior member of the Moffitt Cancer Center’s Division of Population Science in Tampa.

Clement Gwede [Courtesy of Moffitt Cancer Center]

The fact that these disparities have been consistent over time while the overall rate of mortality across racial groups is decreasing suggests that early detection is effective, Gwede said. Yet African Americans are benefiting at a slower rate, he said.

Researchers say the disparities’ causes are complex. Factors include limited access to care, not enough awareness of the heightened risk, inadequate communication between providers and patients, and the need for more dialogue within families about their medical history.

People with a family history of colorectal cancer are at greater risk for being diagnosed with the disease and should start a dialogue with their primary care doctor about screening.

Additionally, the decrease in age of diagnosis is a rising concern among researchers and doctors.

“We’re seeing more patients with colon cancer who are younger than 50,” said Dr. Jorge Marcet, a colorectal surgeon at USF Health. The trend, which goes back about 10 to 15 years, led the American Cancer Society to lower the recommended screening age from 50 to 45 about two years ago, Marcet said. For now, researchers are unable to explain the rise in patients under 50.

Dr. Jorge Marcet [ Courtesy of USF Health ]

In Tampa Bay, the racial gap in colorectal cancer screenings has narrowed in recent years, said Gwede. Yet he fears the reduction in frequency of screenings amid the coronavirus outbreak may drive an increase in the number of advanced-stage cancer diagnoses after the pandemic.

And researchers anticipate the burden will again disproportionately impact communities of color.

Diagnoses of higher stage colorectal cancer following the pandemic will “simply mirror the disparities we already see before (COVID-19),” Gwede predicted. “Meaning certain racial/ethnic groups — Blacks, Latinos, and immigrants — may be less likely to be screened and therefore be more likely to have a higher stage of diagnosis as a result of (COVID-19).”

He said that only builds on disparities that already exist.

“Cancer, unfortunately, doesn’t wait for (COVID-19) to die down,” said Gwede, who points out there are ways to remain safe from the virus and visit a doctor for screening.

“Colon cancer is the most preventable, the most detectable, the most treatable, and the most beatable if it’s found early,” he said.

Symptoms for colorectal cancer can include changes in bowel movements, blood in the stool, and abdominal pain. Yet, “the most common presentation is asymptomatic,” said Dedania, the gastroentrologist who fielded the Monday morning call from a Black male patient.

Dr. Bhavtosh Dedania of The Gastroenterology Center of Tampa Bay. [ Courtesy of Florida Digestive Health Specialists ]

“If (you) feel there has been a change, talk to a physician,” said Dedania, who is working to chip away at the myth that colonoscopies are painful. They are not, he says.

Quitting smoking, adding exercise into your daily routine, cutting down on processed and red meat, and incorporating more fruits and vegetables into your diet are some of the health behaviors that can reduce the risk for colorectal cancer, Dedania said.

But primarily, “the message is you need to get screened,” said Marcet of USF Health. “We know it saves lives.”

He added, “African Americans in particular need to take notice.”

This story was funded in part through a grant from the Foundation for a Healthy St. Petersburg. Donors are not involved in the reporting or editing process.