Exploring Disparities in Colorectal Cancer

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Over the last decade, health systems have put a stronger emphasis on making preventive care accessible and equitable, which has contributed to a reduction in colorectal cancer (CRC) incidence and mortality for the general population. However, significant disparities persist among some racial and ethnic groups.

According to the American Cancer Society 2023-2025 Colorectal Cancer Facts & Figures:

• CRC incidence is highest in American Indian and Alaska Native individuals followed by nonHispanic Black individuals and lowest in Asian Americans/Pacific Islander people.
• Incidence rates in Black individuals were similar to those in White individuals before the late 1980s, but were 25 percent higher by 2010, partly due to less access to high-quality CRC screening and follow-up; this disparity between Black and whites has leveled off at 15 percent since 2017.

Together we can reduce disparities by keeping our attention focused on barriers to health care and preventive services and continuing to educate ourselves and others about colorectal cancer. Howard S. Hochster, MD, FACP, director of the Gastrointestinal Oncology Program and Rutgers Cancer Institute of New Jersey Associate Director for Clinical Research and director of Oncology Research, RWJBarnabas Health recommends: 

Focus on screening and early detection or prevention. While there is no single solution to resolving colorectal cancer disparities, greater access to screening services can result in better health outcomes. Most colorectal cancers can be prevented through regular screening through detection and removal of polyps. It is recommended that colorectal cancer screening for men and women begin at age 45.

Watch for signs and symptoms. Some symptoms include rectal bleeding with or without pain, blood in the stool, a change in bowel pattern, bloating, cramping, and unexpected weight loss (even with dieting) and/or fatigue.

Know your family history. According to the American Cancer Society, most colorectal cancers are found in people without a family history of colorectal cancer. People with a history of colorectal cancer in a first-degree relative (parent, sibling, or child) are at increased risk. f you have a family history colorectal cancer, talk with your doctor about the possible need to start screening before age 45.