Colorectal Cancer Screening: The Silver Lining

When I heard the news this weekend about the passing of Chadwick Boseman, like many I was shocked and sad that another young life was taken by this disease. Chadwick chose to keep his diagnosis and treatment private. Whether or not to share a cancer diagnosis with friends and acquaintances is a deeply personal one and there is no right answer. But now that we know, what we do with this information can take a terrible situation and add a silver lining? If Chadwick’s death helps people learn about colorectal cancer and the screening tests that can save lives, and perhaps prevents someone from developing the disease, then we will have a silver lining.

While colorectal cancer (CRC) occurs in all people, it is the 3^rd most common cancer in both Black men and women. Black men and women have the highest rates of CRC in any racial or ethnic group. And when diagnosed, they are more likely to die from the disease than whites with the disease.  

Most people think of CRC as a disease that affects older people. However, cases in people ages 20-49 have risen by 51% since 1994 – and continue to rise about 2% every year. The American College of Gastroenterology recommends African Americans begin CRC screening at age 45, while others should begin at 50. The American Cancer Society (ACS) recommends that all people should begin CRC screening at age 45. Obviously screening at 50 is not going to help someone like Chadwick, who developed the disease in his late 30s. Add to this that not all insurance companies will pay for screening in people under 50 – despite the ACS recommendations.

We know that screening has had an effect – slowly decreasing the number of CRC cases over the last 30 years. But black men and women are less likely to have their healthcare providers recommend CRC screening and when recommended, they are less likely to have the test. Sadly, CRC and the screening tests for it have a lot of negative stigma and this is preventing people from being screened and preventing or finding the disease at an early stage.

We need better ways to test younger people for CRC. We need tests that more people are willing to have. We need to talk to our families about family health history. We need to know our own bodies and report unusual symptoms. We need to advocate for ourselves when we aren’t being heard by our healthcare providers. We have a lot to do. But for starters, let’s make a silver lining to Chadwick’s story.

Start by educating yourself, knowing your own body, and advocating for yourself and your community!

• Know the symptoms to look for and report to your provider:
  • Change in your stools (diarrhea, constipation, thin or pencil-like stools) lasting for more than a few days.
  • Feeling like you need to move your bowels that is not relieved after you do.
  • Blood in your stool (may be bright red or make stools appear very dark or black).
  • Pain or discomfort in your belly, including frequent gas pains, bloating, and cramps.
  • Weight loss with no reason for it.
  • Unexplained anemia (low red blood cell counts).
• You know your own body. If things don’t seem right, talk with your healthcare provider. Don’t dismiss your gut feeling – continue to speak up and seek help, even if it means seeing another provider.
• Talk to your family to learn about cancer in the family. Remember though, not having cancer in your family does NOT mean you are not at risk for CRC!
• Exercise and eat healthy. Being overweight and diets high in animal fat (eating red meat and processed meat) lead to a higher risk of CRC.
• Don’t smoke – smokers are more likely to die of CRC than non-smokers. If you smoke, make a plan to quit.
• Talk with your healthcare provider about when you should have CRC screening. This discussion should consider your own health history and your family’s. Inflammatory bowel diseases (ulcerative colitis, Crohn’s disease) can increase risk as well as some genetic syndromes.
• While colonoscopy is the test most often recommended, there are other tests, including stool tests that may be an option for you. The BEST test for you is the one you WILL have.
• Remember that the goal for colonoscopy screening is to detect polyps BEFORE they can become cancer.
• Be a voice in your community. Get your screening, talk about it, recommend others do it. Be the boots on the ground to change these statistics!
• You want more? Advocate for changes in insurance coverage to allow these tests to be covered for younger people. Organizations like the Colon Cancer Alliance and Fight Colorectal Cancer are advocating for increased screening.

It was heart-warming to see so many people sending love and sympathy to Chadwick’s family and sharing their memories of his life. His family’s tweet about his death went viral – becoming the most liked tweet ever. But the real silver lining would be to see the hashtag #GotScreenedforChadwick go viral.

Carolyn Vachani is an oncology advanced practice nurse and the Managing Editor at OncoLink. She has worked in many areas of oncology including BMT, clinical research, radiation therapy and staff development. She serves as the project leader in the development and maintenance of the OncoLife Survivorship Care Plan and has a strong interest in oncology survivorship care. She enjoys discussing just about any cancer topic, as well as gardening, cooking and, of course, her sons.