Each March, we observe Colorectal Cancer Awareness Month in the United States. It was created to highlight the importance of screening for colorectal cancer (CRC), as well as to promote healthy lifestyle habits that can decrease a person's risk of developing cancer of the colon, rectum or anus—which collectively make up the disease.
For Houston-based physician, Dr. Jason Willis, M.D., Ph.D., he's not only leading groundbreaking research on the disease and its effect on the Black community, but he also has a personal passion on raising awareness as his grandmother, two great aunts and his cousin all have been affected.
"My passion for colorectal cancer research and spreading awareness stems from the knowledge of how devastating the disease can be for friends and loved ones. But, with adequate screening and care, colorectal cancer is preventable and highly curable when detected at early stages," Dr. Willis shares. "My hope, and that of a growing research community, is that we can collectively address disparities affecting the Black community and improve outcomes for colorectal cancer, especially for the growing number of young adults at risk."
As our nation continues to observe Colorectal Cancer Awareness Month, it is important to note that although diagnoses have been on a downward trend overall for the past decade thanks to the availability of screening, significant disparities persist for Black Americans, who are more likely to get colorectal cancer at a younger age and die from it than people from other racial groups. In fact, studies show that they are 30% more likely to be diagnosed.
We chatted further with the University of Texas MD Anderson Cancer Center doctor to learn more on how we can spot possible signs, what steps we can take toward prevention and why Black communities tend to be disproportionately affected by the disease.
EBONY: In your professional opinion, why is the Black community disproportionately affected by colorectal cancer?
Dr. Jason Willis: In my review, colorectal cancer disparities affecting the Black community are most likely driven by some complex and interacting layers. First, systemic inequalities in healthcare can disproportionately impact racial/ethnicity minority communities, leading to a lack of access to routine screening, testing, and other preventative care. Furthermore, some evidence has suggested that CRC screening tests such as colonoscopies may be underutilized within the Black community, especially younger men, due to stigma or perception.
Differences in CRC risk may also be driven by disparities in the prevalence of its underlying risk factors such as tobacco use and diabetes within the Black community. Recent work has also focused on comparing the molecular composition of CRC across groups of people with different race/ethnic and ancestry backgrounds. This work has revealed unique molecular features amongst CRC tumors from individuals with Black/African American ancestry. Further research is needed to understand the implications of these molecular and biological differences.
What are some of the signs and symptoms of CRC we should look for early on?
It's important to remember that CRC can be "silent." Many people with colon cancer may not have overt signs or symptoms, especially at an early stage. This is why screening is so vitally important, not only for the prevention of CRC, but also for early detection when a tumor may not be causing symptoms.
The signs and symptoms of colorectal cancer partly overlap with those of many benign gastrointestinal conditions, such as irritable bowel syndrome or hemorrhoids. This presents a challenge and can lead to delays in diagnosis. These signs and symptoms aren't entirely specific to colorectal cancer (meaning, they don't automatically indicate that someone has a diagnosis of cancer). However, when in doubt, speaking with a healthcare provider is always recommended. So, it's very important for everyone to alert their providers about:
- Anemia (specifically, iron deficiency anemia)
- Blood with bowel movements
- Constipation or difficulty passing stool
- Persistent stomach pain, or bloating (may fluctuate in severity depending on bowel movements)
Dr. Willis' advice for colorectal cancer prevention
Get regular screenings: Regular screenings are by far the most important and impactful way to prevent CRC. Dr. Willis strongly encourages every individual to speak with their healthcare provider about the best time to start colon cancer screening based on their age, personal risk factors and family history.
Know your family history: Families are complex, and sharing health information amongst family members is certainly not always easy or straightforward. But, when it comes to colorectal cancer risk and prevention, family medical history plays a major role. Knowledge about a family history of colorectal cancer (including ages of diagnosis) can empower your healthcare provider to determine whether a person might benefit from starting their screening at a younger age than at 45 years old. For example, a person with a parent or sibling diagnosed with CRC at age 45 should start their own screening 10 years prior, at about age 35. In addition, family history can help determine whether some families or individuals may need testing for a hereditary cancer syndrome that could predispose to other cancers as well.
Avoid common risk factors: Research has highlighted important links between CRC risk and tobacco use, a lack of physical activity/exercise and a poor diet lacking in fruits, vegetables, fiber. With guidance and supervision from a healthcare provider, making lifestyle changes (such as quitting smoking), increasing exercise and starting a well-balanced diet may help to reduce risk of CRC along with overall cardiovascular health.