The Atlanta Journal-Constitution
REMINDER: COLON CANCER CAN AFFLICT YOUNG MEN, TOO
We don’t talk nearly enough about things that matter. It’s not surprising then that colorectal cancer hasn’t been on our collective radar until, well, it took the life of one of our heroes, Chadwick Boseman.
Boseman, known for his role as King T’Challa in Marvel’s “Black Panther,” for playing Black icons James Brown, Thurgood Marshall and Jackie Robinson, died Aug. 28 following a four-year battle with colon cancer. He was just 43.
What makes his death particularly tragic is colon cancer is preventable and, when caught in time, it can be beaten.
Boseman, though, had two strikes against him. He was young and he was a Black man.
Not only are colorectal cancer rates the highest among those groups, but it is also rising the fastest, according to Dr. Durado Brooks, an internist
and vice president of prevention and early detection for the American Cancer Society.
Black people are 20% more likely to get colorectal cancer, and are also 40% more likely to die from it than other groups.
Brooks’ answer to that is simple.
“We have got to break the silence,” he said.
And so while we count the cost of losing Boseman, talking about the thing that took him is imperative and more importantly, points to the need for family members to share what ails them with loved ones.
When you know colorectal cancer is in your family, you know it’s important to get screened.
“This is a disease that is prevalent, preventable and, if found early enough, curable,” Brooks said. “Getting screened is the absolute best thing we can do to prevent colorectal cancer and allow people who are diagnosed to have better outcomes.”
Because of Boseman’s celebrity status, it doesn’t surprise me that colorectal cancer has sadly suddenly captured our collective attention. I say sadly not because colorectal cancer is undeserving but because it took Boseman’s death to start the conversation.
Let that sink in because according to news reports, Boseman had been in this fight since at least 2016. In 2018, we learned the American Cancer Society lowered the recommended age at which we should first be screened to 45. That’s because research revealed a steady increase of the disease in people under 50, then the recommended age to begin screening, Brooks said.
In March, the organization launched the social media campaign #ShareYourScreen to encourage people to screen earlier.
If you somehow missed it, it wouldn’t surprise me.
Conversations around such issues seem to only get a notice when they are instigated either directly or indirectly by celebrities. Tarana Burke breathed life into #MeToo a decade ago, but it wasn’t until actress Alyssa Milano tweeted it that it became a worldwide movement. When Michelle Obama took to Twitter to raise awareness for kidnapped Nigerian girls, we all paid attention. And I guess that’s why President Donald Trump prefers listening to the MyPillow guy over his own health experts, namely Dr. Anthony Fauci, when it comes to the coronavirus.
As grateful as I am that we’re finally having conversations about colon cancer, I can’t help wondering how many lives could’ve been saved had we been paying attention sooner.
Colorectal cancer, after all, didn’t just become deadly. It’s always been that way.
Brooks told me that colorectal cancer is the third most commonly diagnosed cancer and the second most common cause of cancer death in both men and women in the United States. About 1 in 23 men and 1 in 25 women will develop colon or rectal cancer at some point during their lifetime.
In fact, it is estimated that there will be 104,610 new cases of colon cancer and 43,340 new cases of rectal cancer in the U.S. this year. What’s more, colorectal cancer is expected to cause about 53,200 deaths this year alone.
Although recent data has shown that new cases of colorectal cancer are on the rise in younger people, certain risk factors like family and personal history make us more likely to develop colorectal cancer.
If you’re like me and have had precancerous colon polyps in the past, you’re also more likely to get a colon or rectal cancer diagnosis. Other conditions like ulcerative colitis, Crohn’s disease, or Type 2 diabetes can also increase your risk.
Black people are more likely to be diagnosed with late-stage colorectal cancer and also have the lowest overall fiveyear survival rate, Brooks said. These disparities are largely driven by socio-economic inequalities that result in differences in access to early detection and timely, high-quality treatment.
“That includes something as simple as no medical insurance,” Brooks said. “People who are uninsured are only about half as likely to get screened even though it can prevent or find it early. Not only are African Americans less likely to be insured, but people living in poverty, regardless of race, have worse outcomes once they are diagnosed.”
Although Boseman didn’t fit any of these categories, his family and personal history could’ve been clues for the need for early screening.
That’s why it’s crucial, Brooks said, for families to share their medical history.
Asked about assertions that insurers are denying coverage for screenings, Brooks said those reports are misleading.
Based on a provision in the Affordable Care Act, most insurers are required to cover screenings with no copay and no deductible. Brooks said, however, that coverage is linked to screening recommendations published by the U.S. Preventive Services Task Force, which still uses 50 as its benchmark.
“The insurance industry has been uneven in changing the age at which they begin to cover colorectal cancer screenings,” he said. “Some still follow the old guidelines while others like Aetna have changed.”
Still, Brooks suggested people check with their insurer to determine eligibility. Even if an insurer is still adhering to the old guidelines, Brooks said there are a variety of colorectal cancer screenings available beyond the standard colonoscopy test, like the Fecal Immunochemical Test, which can cost as little as $35 and are just as effective.
“Most doctors can either give you a kit or send you to a local lab to get one,” Brooks said.
Bottom line: The majority of people who aren’t screened don’t face any barriers. They either choose not to get screened or don’t know they should be screened.
Let’s keep talking and change that.