Chadwick Boseman’s Death Highlights Health Disparities

By Sara Bondell - September 02, 2020

The death of “Black Panther” star Chadwick Boseman at the age of 43 has shed light on the disproportionate affect colon cancer has on Black men and the rising number of young adults diagnosed with the disease.

Clement Gwede, PhD, MPH, RN, senior member of Moffitt’s Division of Population Science
Clement Gwede, PhD, MPH, RN, senior member of Moffitt’s Division of Population Science

“Black men are more likely to be diagnosed with colorectal cancer and die from it than any other group, followed by Black females,” said Dr. Clement Gwede, a researcher at Moffitt Cancer Center who focuses on health disparities.

According to the American Cancer Society, Blacks are about 20% more likely to be diagnosed with colorectal cancer and 40% more likely to die from it.

Gwede says these disparities are two-fold; not only are Blacks dying from the disease at a higher rate, they have less access to screenings to detect cancer early. While all racial groups are benefiting from local and national efforts to educate the public about screening, Blacks are benefiting at a slower rate.

“The mantra is colon cancer is preventable, detectable, treatable and beatable if it is found early,” he said. “We can cure it, but we have to find it early.”

While there has been an increase in the number of Blacks who are getting screened—whether by a colonoscopy or at-home stool test kit—Gwede believes COVID-19 has interrupted that progress.

“After this pandemic, we may see an increase in advanced-stage diagnoses,” said Gwede. “We think this will mirror or exacerbate the disparities we saw before. Blacks, Latinos and immigrants may be less likely to get screened and have a higher stage of disease at diagnosis because of COVID-19-related delays and lack of screening.”

The disease has also seen a rise among young adults. An ACS study found colorectal cancer incidence among adults younger than 50 has been increasing since the mid-1990s. From 2012 to 2016, incidence rates in that age group rose by 2.2% each year. While death rates decreased 3% per year among patients 65 and older between 2008 and 2017, they increased 1.3% in those under 50.

Boseman’s death at 43 made him two years younger than 45, the age at which the ACS recommends screening begin for African Americans. The U.S. Preventive Services Task Force recommends screening start at 50.

“African Americans tend to get colon cancer on the right side of the colon, requiring colonoscopy screening which is more thorough and can reach that area better. Furthermore, they tend to get it at an earlier age and their disease may be more difficult to treat,” said Gwede. “Minority populations also may not know their family history of cancer, which may contribute to delay in seeking screening or result in a surprise early age diagnosis of colon cancer.”

If you have a family history of colorectal cancer, many experts recommend starting screening 10 years before the age at which the family member was diagnosed. Gwede stresses the importance of discussing health history with family members and engaging with health care providers to develop a plan to be screened early if necessary before the onset of symptoms.  Routine screening of asymptomatic individuals is ideal, since many early colon cancers will not have associated symptoms, and when symptoms do appear the disease may be more advanced.

“What we can do is bring awareness about the importance of this disease in Black populations and engage cultural communities where we can reach people who are not seeking health care,” said Gwede. “Our message is early detection saves lives and we want that message to be known in the community so people no longer fear or hesitate to get any of these tests.”

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