Disparities Impact Hispanic CRC Survival Rates



As the United States celebrates Hispanic Heritage Month (Sept. 15-Oct. 15), it is important to recognize the health and well-being of our Hispanic population.

Colorectal cancer (CRC) is the second-deadliest cancer among Hispanic males and the third-deadliest cancer among Hispanic females. These statistics are according to the American Cancer Society's Cancer Facts & Figures for Hispanic/Latino People 2021-2023.

It is estimated that colon cancer causes 2,700 cancer deaths among Hispanic males. Colon cancer causes about 2,000 cancer deaths among Hispanic females, according to ACS data.

Research Targets Early-onset CRC

CRC is not just a disease of the elderly. Early-onset or young-onset cancer means a patient is diagnosed before they turn 50. People diagnosed younger than 50 are more likely to have advanced disease at diagnosis.

A recent study found that racial and ethnic disparities exist in early-onset CRC survival rates.

According to the analysis, the five-year survival rate for Hispanics, Blacks or Asians with early-onset CRC did not improve between 1992 and 2013. The only survival rate improvement noted was in white patients.

Researchers identified more than 33,700 individuals newly diagnosed with early-onset CRC between Jan. 1, 1992, and Dec. 31, 2013. Of these, 58.5 percent were white, 14.5 percent were Hispanic, 14 percent were Black and 13 percent were Asian. Statistics came from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program of cancer registries.

"Our study's identification of disparities among younger Hispanic and Asian adults adds to existing literature," Timothy A. Zaki, MD, the study's lead author, told MedicalXpress. "However, we lack information, such as what treatment these individuals received, that could help explain the disparities, so we are still left with the question of why they exist."

Data also revealed "Blacks had not caught up to whites in surviving early-onset CRC” over a 20-year span.

"Survival for Blacks diagnosed from 2003 to 2013 remained even lower than for whites diagnosed a decade earlier," said Dr. Zaki.

Scientists believe there are reasons for racial and ethnic healthcare disparities. These reasons may include "employment, insurance status, income and education level, behaviors (e.g., tobacco, alcohol, diet), environment (e.g., rural or urban), social support and cultural factors."

"With recommendations now that CRC screening start at age 45 versus 50, one concern is whether health disparities will worsen as a result," Dr. Zaki told MedicalXpress. "If more are screened who have the means and inclination to do so — but we fail to make progress in other populations — we could see these gaps widening."

Don't Delay Colon Cancer Screening

Healthcare agencies recommend CRC screenings begin at age 45 for those at average risk for the disease. Individuals should be screened even if they don't have symptoms. The five-year survival rate for CRC is about 90 percent when it is found at an early stage before it has spread.

In 2018, colon cancer screening prevalence was 9 percent lower among Hispanics than non-Hispanic white adults 45 years of age and older, according to the ACS.

Colonoscopy is the preferred method for screening because colon cancer can be both detected and removed during the same procedure. Other screenings can detect the presence of cancer cells or hidden blood in the stool, but a positive test result means a patient will need a follow-up colonoscopy.

Health insurance plans within the Affordable Care Act provide no-cost coverage for preventive and follow-up colonoscopy screenings. Contact your provider to determine your coverage.

If you do not have insurance, there are resources to learn about a low-cost or free colonoscopy. Some resources include the Colorectal Cancer Alliance Helpline, ColonoscopyAssist or your state's health and human services or department of health.

Patients who are at high risk for colon cancer may need to be screened before age 45. In addition, patients with digestive symptoms should seek medical attention regardless of age. Colonoscopy should always be the screening test of choice for those who have any of the following:

  • Previous CRC diagnosis
  • History of adenomas
  • Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
  • Family history of colon cancer or certain types of polyps
  • Inherited colon cancer syndrome (e.g., Lynch Syndrome)

It is important to discuss CRC risks and symptoms with your family and doctor. It is also important to get screened. Both may save your life or the life of a loved one. If you have a family history of colon cancer, or you are experiencing digestive symptoms, call a GI specialist today. Search for a gastroenterologist in your area.