Black Americans’ increased risk for colorectal cancer

The recent death of actor Chadwick Boseman — known for his regal performance in “The Black Panther” — due to colorectal cancer was a harsh reminder of the toll this cancer has taken on the Black community. Boseman was just 39 when he was diagnosed with colorectal cancer, the third most common cancer diagnosed in the U.S., and the second most common cause of cancer-related death.
Each year, approximately 150,000 Americans are diagnosed with colorectal cancer, also known as colon cancer or rectal cancer. Among all racial groups in the U.S., Black Americans have the highest likelihood of getting colorectal cancer and dying from it.
“Black Americans are approximately 20% more likely to get colorectal cancer and 40% more likely to die from it,” says Dr. Marilyn Norton, a hematologist and oncologist affiliated with Sharp Chula Vista Medical Center. “However, the reasons for this cannot be easily explained as a matter of genetics.”
According to Dr. Norton, Black adults are at greater risk for — and disproportionately affected by — colorectal cancer due to a variety of factors. These include possible biological and environmental factors, as well as systemic racism, which can lead to increased stress, decreased access to healthy and affordable food, and an unfair inability to attain health insurance and quality health care.

The importance of colorectal cancer screening
“We know that colorectal cancer screening, early detection and appropriate treatment can vastly improve one’s chance of survival,” says Dr. Norton. “With improved access to health insurance and health care, Black Americans will then have increased opportunities for preventive medical care, screenings and early detection of signs of cancer, and it’s vital that we work together to make this a reality.”
Additionally, while colorectal cancer is more common in older adults, it is important to note that Boseman was 43 at the time of his death, highlighting another troubling trend in colorectal cancer rates — the increase in colorectal cancer diagnoses in people under 50. In 2020, this age group accounted for approximately 12% of colorectal cancer cases, nearly (https://www.cancer.gov/news-events/cancer-currents-blog/2020/colorectal-cancer-rising-younger-adults#:~:text=Rising Rates around the World,than 1% of younger adults.). However, colorectal cancer rates in people over 50 have decreased over the same time period.
According to the National Institutes of Health (NIH), studies have shown that when the American Cancer Society’s recommended age to begin colonoscopy screening was lowered to 45 years old — and earlier for those at increased risk, such as people with a family history of colon or rectal cancer — screening in Black adults increased. What’s more, the increase in early screening has been credited for a recent decrease of colorectal cancer in this population.

Know your personal risk factors, beyond race and age
Dr. Norton acknowledges that race and age are colorectal cancer risk factors that cannot be changed. However, she says that knowing the risk factors that people can change, regardless of their race and age, is important.
Factors that increase colorectal cancer risk that people can change include:

• Being overweight or obese

• Not being physically active

• Consuming a diet high in red meats, processed meats and meats cooked at very high temperatures (as when fried, broiled or grilled)

• Smoking

• Moderate to heavy alcohol use

“Certainly, we should continue to look at biological, environmental and lifestyle factors that might increase Black Americans’ risk for colorectal cancer,” says Dr. Norton. “But we must also remain committed to making systemic changes to ensure that Black Americans have equal access to a high quality of life and quality health care.”

Colorectal cancer is highly treatable when detected early with screening. Learn more about how you can reduce your risk and schedule a screening.