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• Posted July 24, 2024

Better Screening Key to Closing U.S. 'Race Gap' in Colon Cancer Deaths

Black Americans are almost a third more likely to die from colon cancer than their white peers, and one key to closing that divide could be better cancer screening, a new report finds.

That means getting Black Americans quality colonoscopies and other forms of screening, but also making sure they're followed up after their test results come in.

"Our study shows that it's not enough to just get everyone screened; the quality of care during screening and follow-up must also be similar for Black and white adults," explained study lead author Oguzhan Alagoz. He's a professor of industrial and systems engineering at the University of Wisconsin-Madison.

The findings were published July 24 in the Journal of the National Cancer Institute.

As Alagoz' team noted, compared to whites, Black Americans are still 23% more prone to receiving a colon cancer diagnosis and about 31% more likely to die from the disease.

Some of this disparity had been blamed on lower rates of recommended colon cancer screening among Black patients versus whites. However, over the past two decades that gap has closed.

For example, in 2005, one study found that 52% of white Americans said they were up to date on their colon cancer cancer screenings, compared to to just 39% of Black people.

By 2019, however, that disparity had vanished: 69.5% of Black people and 69.8% of White people said they'd been keeping up with their screenings, the data showed.

So, why are Black Americans still dying of colon cancer at higher rates?

As the Wisconsin team noted, it's one thing to get screened and another to get proper and timely follow-up (for example, follow-up colonoscopies, biopsies) if your colon cancer screen comes back positive.

According to the researchers, Black patients do have significantly lower rates of follow-up than whites. The colonoscopy services Black patients receive tend to be of lower quality, as well.

What if those disparities were eliminated?

Using sophisticated mathematical modeling, Alagoz and colleagues calculated that if the gap in proper follow-up was eliminated, that could cut the race gap for colon cancer incidence by 5.2%, and for colon cancer deaths by 9.3%.

Making the quality of colonoscopies equal for white and Black patients would further reduce the gap in colon cancer incidence by 14.6%, and colon cancer deaths by 18.7%, the study found.

Doing both those things would result in racial disparities in colon cancer incidence shrinking by 49% overall, and the disparity in colon cancer deaths would be reduced by 59%, the team concluded.

Alagoz' group noted that these gaps wouldn't be completely eliminated, even with better screening and follow-up.

That's because other factors -- for example, racial differences in overall health and access to care -- probably play a role, as well.

All of this means that, "to truly close the racial gap in cancer deaths and achieve health equity, we need to find innovative solutions," Alagoz said in a journal news release.

More information

The American Cancer Society has more on colon cancer screening.

SOURCE: Oxford University Press, news release, July 24, 2024