Considering that March was designated as National Colon Cancer Awareness Month in 2000, there is no time like the present for us, as Black women, to know more about how this form of cancer is really impacting us. Knowledge is power, and screenings save lives.
“If we’re aware of it, then screening and education can prevent these high numbers,” said Lynn O’Connor, M.D., director of the Women’s Colorectal Care Program at ProHealth Care Associates in New York City. “In the African American community, the woman is often the one who holds all of the information to the family history — the mothers and grandmothers. The health of the family is resting on those shoulders. So, to be able to have awareness, know about it, to spread the word and allow our community to heal and thrive like others is important.”
So, why is colon cancer so prevalent in our community? Why are we more likely to get it and less likely to survive from it? There are a number of reasons for this, and they include everything from our ability to seek medical help to what we’re being told and not being told when we get in the doctor’s office.
“If you look at it, there are socioeconomic issues, there are awareness issues, there is trust of the medical community issues, health disparities, and the fact that a lot of physicians aren’t aware of these new guidelines that are talking about screening African Americans at age 45 rather than 50,” O’Connor says. “We’ve got a lot of obesity in the African-American race, there are sedentary issues, the lifestyle with not enough exercise, the risk factors of smoking and drinking — those are the things we really need to get under control. But if you look at a lot of the facts, folks don’t understand that there should be increased screenings and screenings at an earlier rate. And the socioeconomic factors are huge in terms of our access to care, the disparities and just having your own physician recognize that this is something that needs to be done. People need to be moved towards screenings.”
With that being said, it’s recommended by experts like O’Connor that while White patients are often recommended to start screening for this cancer at 50, we should start getting screenings for colon cancer at 45. That’s due to the more aggressive stages Black men and women are often in when diagnosed at the time of their initial colonoscopies. However, if there is a history of colorectal cancer in one’s family, the earlier the better. And while the screening might sound intimidating, O’Connor says they can go by quickly and patients leave comfortably.
“It’s an outpatient procedure that takes about half an hour,” she says. “The patient is completely asleep and they don’t wake up groggy. They actually feel like they can drive, but we don’t let them drive because there is anesthesia. So when they come in, if I’m doing the screening, I’m looking at the entire colon. If there’s a polyp, I’m removing it right then and there.”
But if something is spotted that is too large or too complex for a quick colonoscopy, things are taken up a notch.
“If there’s something that is too large to remove, a biopsy is taken,” she says. “The patients prepare with a clear liquid, which is extremely important so that we’re able to completely clean the colon and get a good examination. And they do a prep. Most patients do fine with this and don’t even feel like they’ve had a colonoscopy when they wake up. They resume their normal activities, they resume their normal eating habits. Hopefully they can use it as a fresh start (laughs).”
O’Connor stated that while these measures are recommended for every 10 years, it’s “still too long.” She preferred the idea of every five years. However, if you don’t get in screenings before you start feeling like something is off, you need to see your doctor immediately. Symptoms like rectal bleeding are a major red flag. “The majority of rectal bleeding is benign, but you can’t just rule that out,” O’Connor says. Other red flags include a change in bowel habits, like a difficulty in evacuating, change in size or color, and abdominal pain.
“Those are usually why we try to have people screened. By the time symptoms have come, the disease may be so far gone where you’re at more advanced stages,” she says. “A simple colonoscopy with a polypectomy could have resolved the situation, but now we’re looking at possibly having surgery for cancer.”
But before you seek out screenings, what efforts are you making to clean up your diet? Poor diet can put you at risk for colon cancer, as with many others. Foods high in nitrates have been linked to increased risks while foods high in fiber, as well as fruits and veggies, help you remove your bowel more frequently and lower risks. And exercise, even short amounts, can go a long way.
“There are some studies that have shown that out of a cohort of people who exercise just generally 30 minutes a day, their risk of having colon cancer was 24% less,” O’Connor said. “Nothing is 100%, but if you can lower your risk by eating right, exercising, proper food and vegetables and things of that nature, then that’s important before having to get a screening.”