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As a gastroenterologist, I fully understand that conversations about colorectal cancer can be uncomfortable. Who wants to willingly talk about their health “down there”? But the truth is, we should all be openly discussing colorectal cancer and how to prevent it, especially within the Black community.

Unfortunately, colorectal cancer is the second leading cause of cancer-related deaths among Americans, with Black Americans having a 40% higher death rate compared to white Americans. Despite these stats, the good news is that if caught and treated early, colorectal cancer has a 90% survival rate.

As part of the effort to bring more awareness to racial disparities in colorectal cancer, I’m partnering with Cottonelle and non-profit BLKHLTH to talk about the importance of screening and the impact colorectal cancer has on the Black community.

Through my work as a health equity researcher, I know that health disparities are caused by differences in social determinants of health — the economic, environmental and social context of our everyday lives. Due to historic and current events, structural policies and lack of health insurance, information and health care providers, Black Americans are less likely to know the importance of getting screened regularly. They are also less likely to have access to timely, high-quality health care. Because we know that screening saves lives and that early treatment is critical for survival, these factors help explain why we see poor outcomes among Black Americans.

There is a hesitancy about colonoscopies among most patients, but hesitancy tends to be higher among Black Americans. There are stigmas in the Black community about seeking colonoscopies, which require visitation to a medical center, conscious sedation or anesthesia, and instrumentation through the rectum, which many consider invasive. Sometimes seeking care with a Black provider, or just having a better understanding of what a colonoscopy is and why it is important, can make all the difference.

Alongside fellow Black medical professionals, I recently co-founded the Association of Black Gastroenterologists and Hepatologists to address some of these stigmas and to provide resources for Black patients.

My hope is to help my patients and the Black community understand the value of colorectal cancer screening. It is essential to keep up with routine screening, and there are many options to do so. Even when colonoscopy is not desired, other screening tests are effective to prevent colorectal cancer deaths, including the Fecal Immunochemical Test (FIT). Many people choose the FIT option or other stool-based screening options because they can be done in the privacy of your own home in minutes and with no colon prep required.

Here are a few ways you can be proactive in caring for yourselves down there:

– Understand risk factors such as increasing age (colorectal cancer is most common in individuals over age 50, but is rising among people who are younger than age 50), family history, lifestyle-related factors like poor diet and smoking, and conditions like inflammatory bowel disease (IBD).

– Watch out for symptoms like change in bowel habits, persistent abdominal discomfort, blood in the stool, feeling weak/fatigued or unexplained weight loss.

– If you notice any of the symptoms mentioned above, contact your medical provider immediately, or reach out to a care provider at the Colorectal Cancer Alliance at (877) 422-2030.

– Maintain your annual physicals with your primary doctor to ensure that you are up to date on screening.

The U.S. Preventive Services Task Force recommends screening beginning at age 50. Individuals with a family history of colorectal cancer should begin screening at age 40 or even earlier in some cases. The American College of Gastroenterology recommends Black Americans get screened at age 45. However, family and medical history may recommend screening at age 40 or earlier.

– Talk to your friends and family about their risk of colorectal cancer. Help to reduce the stigma around getting screened by challenging three loved ones to complete a screening.

Colorectal cancer doesn’t have to be a secret. The more we can open up about it as a community, the less stigma there will be. Let’s get #GoodDownThere.

Dr. Fola May

Writing since February 2022 · 1 story contributed