Chadwick Boseman’s Death Sheds Light on the Racial Disparity in Colon Cancer Rates
Black people are more likely to get—and die from—colon cancer than white people.
By
Sarah Jacoby
Last week Chadwick Boseman, star of films including
Black Panther and
Da 5 Bloods, died at the age of 43, just four years after being diagnosed with
colon cancer. Boseman, who did not share his diagnosis with the public, worked on numerous projects while privately managing the disease and undergoing treatment.
“It is with immeasurable grief that we confirm the passing of Chadwick Boseman,” a statement posted to
Boseman’s Twitter account reads. Boseman was diagnosed with stage III colon cancer in 2016, but it progressed to stage IV over the past few years. “A true fighter, Chadwick persevered through it all, and brought you many of the filmsyou have come to love so much…,” the statement continues. “All were filmed during and between countless surgeries and chemotherapy.”
We don’t have any details beyond the statement that tell how he was privately treating this serious health condition while continuing to work, including any screening he may have received. But we do know that colon cancer is a condition that disproportionately affects and disproportionately kills Black people.
Colon cancer typically starts as small clumps of cells (polyps) in the colon that aren’t cancerous, the
Mayo Clinic explains. The polyps might not cause any symptoms—especially at first—but over time they may become cancerous.
As the polyps grow and as the cancer becomes more advanced, however, someone may be more likely to notice symptoms such as a change in bowel habits (like more diarrhea or constipation than usual for a prolonged period of time) or feeling as though they haven’t emptied their bowels completely after going to the bathroom. The exact symptoms a particular person will have depends on the size of their cancer and exactly where it is within the colon.
Catching colon cancer earlier may make it easier to treat in some cases, which is why screening is important. For people without any extra risk factors for colon cancer, screening generally
begins between ages 45 and 50 with regular tests, which could include stool tests and/or colonoscopies,
according to the American Cancer Society (ACS).
Some people are at a higher risk for colon cancer, though, and may need to start screening earlier or have it done more frequently. For instance, those with underlying intestinal conditions (like Crohn’s disease or ulcerative colitis) or who have a family history of colon cancer, as well as those with certain lifestyle risks (like smoking, excessive use of alcohol, and eating a low-fiber diet), may be considered to have a higher risk for colon cancer. Unfortunately, young people (under age 55) are increasingly developing and dying from colon cancer,
SELF explained previously, although the risk for people in this age group is still low overall.
Boseman’s death brings new light to another risk factor that doesn’t get discussed often enough: Overall, the five-year survival rate for colorectal cancer (which includes both colon and rectal cancers) is about 65%, according to data from the
Centers for Disease Control and Prevention (CDC). But despite an overall drop in colon cancer diagnoses and mortality rates in the past few decades,
research suggests that Black people are still significantly more likely to get colon cancer and die from it than white people in the U.S.
For every 100,000 white men in 2017, the most recent year for which
CDC data are available, there were 41 new cases of colorectal cancer and 16 deaths. But for every 100,000 Black men, there were 48 new cases and 22 deaths. Colon cancer is less common among women, but the racial disparity is still there. For every 100,000 white women in 2017, there were 32 new cases of colorectal cancer and 11 deaths; for every 100,000 Black women, there were 35 new cases and 15 deaths.
Due to these disparities, there’s been
a recent push among experts to start screening Black people for colon cancer earlier than age 50. In fact, the
American College of Gastroenterology recently updated its guidelines to recommend that Black people with an average risk for colon cancer begin screening at age 45 while people in other racial groups with an average risk can wait until age 50. The
U.S. Preventive Services Task Force recommends those with average risk start at age 50 regardless of race, and the
ACS recently updated its recommendations to say that those with average risk should start screening at age 45, regardless of race.
Experts don’t totally understand why there’s such a significant disparity here, but part of it may have to do with the way colon cancer presents in Black people compared with white people. Among Black people, the cancer is more likely to appear deeper in the colon, where it’s less likely to present with noticeable worrying symptoms (like bright red blood in the stool), compared with white people,
research suggests.
But that’s only one piece of the issue, as
significant barriers to accessing health care, appropriate screening, and adequate treatment are often prevalent in communities of color due to structural inequities. For instance,
research indicates that health care providers generally do not recommend colorectal cancer screening often enough—especially to Black patients. And once diagnosed, Black patients are less likely to receive
chemotherapy and
surgery than white patients. There are multiple factors at play here, but unequal access to health care
seems to be a driving force in the racial disparities in colon cancer treatment.
There are some things you can do to help reduce your own risks. As with any serious health condition, it’s important to be aware of the risk factors for colon cancer, to monitor yourself for any changes in your bathroom habits that could signal an issue, and to have open, honest discussions about your situation—and whether or not early screening is appropriate—with your doctor. Ultimately, though, it’s beyond any single individual’s power to change a broken system that continually fails to provide Black people and other communities of color with access to the knowledge, tools, and care they need to stay safe and healthy.
What you need to know about screening, treatment, and more.
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