COLON CANCER — THE ‘SILENT KILLER’… Black men urged to get a colonoscopy sooner than later

PITTSBURGH NATIVE GREGORY E. WOODS, 66, URGES BLACK MEN TO GET A COLONOSCOPY.

by Marcia Liggett, For New Pittsburgh Courier

Chadwick Boseman became the face of Marvel Studios’ “Black Panther,” a character widely recognized for symbolizing racial pride and empowerment for Black America. On screen, Boseman’s character embodied unparalleled strength and seeming immortality. Off the screen, his unexpected death at age 43 from colon cancer drew national attention to the importance of engaging in routine screening tests.

As with all Black men in America, Boseman falls into a high-risk category for developing colon cancer. The American Cancer Society (ACS) reports that Black people have the second-highest incidence of colorectal cancer in the U.S., following the Alaska Native/American Indian population.

According to the Centers for Disease Control and Prevention (CDC), “Colorectal cancer is a disease in which cells in the colon or rectum grow out of control. Sometimes it is called colon cancer, for short. The colon is the large intestine or large bowel. The rectum is the passageway that connects the colon to the anus.”

DR. JOHANNA VIDAL-PHELAN, WITH UPMC.

Dr. Johanna Vidal-Phelan, a pediatrician with UPMC, explained to the New Pittsburgh Courier why Black Americans face greater risks for contracting colon or colorectal cancer.

“According to the American Cancer Society, in 2023, an estimated 153,020 people will be diagnosed with colorectal cancer (CRC) in the U.S., and 52,550 people will die from the disease,” Dr. Vidal-Phelan shared. “Colorectal cancer mortality rates were historically higher in White people than in Black people but have reversed and are now 44 percent higher in Black men and 31 percent higher in Black women compared to Whites.”

The 2022-2024 ACS study shows colorectal cancer is the third-leading cause of cancer death in Black men and women (similar to the general population) and incidence rates are about 20 percent higher in Black people than in White people among both men and women.

Many changing patterns in risk factors, coupled with a lack of preventative screening among African Americans, have attributed to the increases. Factors that increase risk for colorectal cancer include: Excess body weight; Type 2 diabetes; Physical inactivity (colon only); Long-term smoking; High consumption of red or processed meat; Low calcium intake; Moderate to heavy alcohol consumption; and very low intake of fruits and vegetables and whole-grain fiber.

Genetic factors and family health histories also play a role in the likelihood of developing colon cancer. Common risk factors include: Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease); Genetic condition as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome); A personal history of colorectal cancer or adenomatous polyps; and a strong family history of colorectal cancer or polyps.

Some symptoms of colorectal cancer may be detectable, such as changes in bowel habits, abdominal pain, cramps or aches that don’t improve, blood in or on the stool, and weight loss.

“The majority of people with colorectal cancer have no symptoms,” Dr. Vidal-Phelan explained. “Assuming that you need to have symptoms before you get checked is not correct. That’s why screening or checking is the best tool to avoid colorectal cancer. If people delay, it can be too late by the time they are diagnosed.”

To put it plainly, colorectal cancer can be a silent killer.

According to the ACS, 90 percent of all colorectal cancer cases and deaths are preventable by removing polyps and cancer can be successfully treated — and often cured — when detected early.

66-year-old Pittsburgh native Gregory E. Woods, who now lives in Capital Heights, Md., is of both Black and Native American heritage. He explained to the Courier his initial hesitancy about getting tested. “In this country the chances of being treated badly by doctors are high. I had a distrust for having procedures completed by White doctors due to their long history of unethical medical mistreatment of Blacks and Native Americans,” Woods said.

“I didn’t understand what a colonoscopy was,” Woods continued. “For the majority of my life I had good health, so I didn’t think I needed one.”

After discussing the screening process with a medical provider that he trusted, Woods agreed to be tested when he was in his 50s.

To date, Woods has had three traditional colonoscopies performed, and expresses gratitude to his doctor for locating and removing the polyps, which ultimately prevented him from having colon cancer. He urges people to find trusted healthcare providers and to participate in routine screenings.

“In communities of color, the incident of screening is different. When we are diagnosed with colon cancer, sometimes it is farther advanced,” Woods told the Courier. “We have a higher risk, so we need to overcome the hesitancy and get screened, which is so important.”

When addressing cost, Dr. Vidal-Phelan said: “Screenings are covered under the Affordable Care Act (ACA). It requires both private insurance and Medicare to cover the cost for screening. This does not apply to ‘grandfathered plans’ (plans that were in place before September 23, 2010). You can call your member services line or resource to confirm that it’s covered.”

The ACA states that “in most cases there should be no out-of-pocket costs (such as co-pays or deductibles) for these tests.”

With several screening options available, Dr. Vidal-Phelan emphasized the importance of patients discussing with their doctor the appropriate testing option for their situation. “A colonoscopy is a visual test where the doctor actually sees your colon and they can see if there are polyps. If the stool test is positive, you will need a colonoscopy.”

She further explained that during painless colonoscopy tests, the doctor is able to see and remove polyps, or biopsy areas of concern, which is not possible with stool tests.

There are three alternative screenings: FIT-DNA (or stool DNA) test like Cologuard, Fecal immunochemical test (FIT), or Guaiac-based fecal occult blood test (gFOBT).

“Cologuard is accurate, but it is not for everybody.” Dr. Vidal-Phelan explained. “If you are having symptoms of colorectal cancer, which are a change in bowel habits, abdominal pain, cramps, aches that don’t improve, blood in your stool, or weight loss, you probably need a colonoscopy. Talk to your doctor. Cologuard may not be what’s best for you.”

Doctors instruct people with inflammatory bowel disease, ulcerative colitis, Crohn’s disease, a personal history of colon cancer or polyps, a strong family history of colorectal cancer or polyps, or a genetic condition that predisposes them to polyps, to have a colonoscopy before the age of 45. “Completely normal colonoscopies only have to be repeated every 10 years,” Dr. Vidal-Phelan explained. “FIT-DNA tests like Cologuard must be repeated every three years. The FIT test and gFOBT require testing every 12 months.”

The U.S. Preventive Services Task Force now recommends that men and women who are as young as 45 years old, up to 75, be screened for colorectal cancer. Dr. Vidal-Phelan urges everyone to talk to their doctor, as depending on family history, risk factors and personal symptoms, they may need to be screened before the age of 40. Boseman was diagnosed with colon cancer prior to turning 40.

Having a colonoscopy is the most comprehensive colon cancer screening available and is the most effective tool for detecting abnormalities and preventing colon cancer. dence rates are about 20 percent higher in Black people than in White people among both men and women.

Many changing patterns in risk factors, coupled with a lack of preventative screening among African Americans, have attributed to the increases. Factors that increase risk for colorectal cancer include: Excess body weight; Type 2 diabetes; Physical inactivity (colon only); Long-term smoking; High consumption of red or processed meat; Low calcium intake; Moderate to heavy alcohol consumption; and very low intake of fruits and vegetables and whole-grain fiber.

Genetic factors and family health histories also play a role in the likelihood of developing colon cancer. Common risk factors include: Inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease); Genetic condition as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome); A personal history of colorectal cancer or adenomatous polyps; and a strong family history of colorectal cancer or polyps.

Some symptoms of colorectal cancer may be detectable, such as changes in bowel habits, abdominal pain, cramps or aches that don’t improve, blood in or on the stool, and weight loss.

“The majority of people with colorectal cancer have no symptoms,” Dr. Vidal-Phelan explained. “Assuming that you need to have symptoms before you get checked is not correct. That’s why screening or checking is the best tool to avoid colorectal cancer. If people delay, it can be too late by the time they are diagnosed.”

To put it plainly, colorectal cancer can be a silent killer.

According to the ACS, 90 percent of all colorectal cancer cases and deaths are preventable by removing polyps and cancer can be successfully treated—and often cured—when detected early.

66-year-old Pittsburgh native Gregory E. Woods, who now lives in Capital Heights, Md., is of both Black and Native American heritage. He explained to the Courier his initial hesitancy about getting tested. “In this country the chances of being treated badly by doctors are high. I had a distrust for having procedures completed by White doctors due to their long history of unethical medical mistreatment of Blacks and Native Americans,” Woods said.

“I didn’t understand what a colonoscopy was,” Woods continued. “For the majority of my life I had good health, so I didn’t think I needed one.”

After discussing the screening process with a medical provider that he trusted, Woods agreed to be tested when he was in his 50s.

To date, Woods has had three traditional colonoscopies performed, and expresses gratitude to his doctor for locating and removing the polyps, which ultimately prevented him from having colon cancer. He urges people to find trusted healthcare providers and to participate in routine screenings.

“In communities of color, the incident of screening is different. When we are diagnosed with colon cancer, sometimes it is farther advanced,” Woods told the Courier. “We have a higher risk, so we need to overcome the hesitancy and get screened, which is so important.”

When addressing cost, Dr. Vidal-Phelan said: “Screenings are covered under the Affordable Care Act (ACA). It requires both private insurance and Medicare to cover the cost for screening. This does not apply to ‘grandfathered plans’ (plans that were in place before September 23, 2010). You can call your member services line or resource to confirm that it’s covered.”

The ACA states that “in most cases there should be no out-of-pocket costs (such as co-pays or deductibles) for these tests.”

With several screening options available, Dr. Vidal-Phelan emphasized the importance of patients discussing with their doctor the appropriate testing option for their situation. “A colonoscopy is a visual test where the doctor actually sees your colon and they can see if there are polyps. If the stool test is positive, you will need a colonoscopy.”

She further explained that during painless colonoscopy tests, the doctor is able to see and remove polyps, or biopsy areas of concern, which is not possible with stool tests.

There are three alternative screenings: FIT-DNA (or stool DNA) test like Cologuard, Fecal immunochemical test (FIT), or Guaiac-based fecal occult blood test (gFOBT).

“Cologuard is accurate, but it is not for everybody.” Dr. Vidal-Phelan explained. “If you are having symptoms of colorectal cancer, which are a change in bowel habits, abdominal pain, cramps, aches that don’t improve, blood in your stool, or weight loss, you probably need a colonoscopy. Talk to your doctor. Cologuard may not be what’s best for you.”

Doctors instruct people with inflammatory bowel disease, ulcerative colitis, Crohn’s disease, a personal history of colon cancer or polyps, a strong family history of colorectal cancer or polyps, or a genetic condition that predisposes them to polyps, to have a colonoscopy before the age of 45. “Completely normal colonoscopies only have to be repeated every 10 years,” Dr. Vidal-Phelan explained. “FIT-DNA tests like Cologuard must be repeated every three years. The FIT test and gFOBT require testing every 12 months.”

The U.S. Preventive Services Task Force now recommends that men and women who are as young as 45 years old, up to 75, be screened for colorectal cancer. Dr. Vidal-Phelan urges everyone to talk to their doctor, as depending on family history, risk factors and personal symptoms, they may need to be screened before the age of 40. Boseman, the actor who passed away, was diagnosed with colon cancer prior to turning 40.

Having a colonoscopy is the most comprehensive colon cancer screening available and is the most effective tool for detecting abnormalities and preventing colon cancer.

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