The Inequitable Cost of Early-Onset Colorectal Cancer: The Continued Significance of Race in the Battle Against CRC

This escalating issue is disproportionately and terribly unfairly affecting African Americans in particular. And we should all be concerned about that.

Although It is Not for Everyone, Early-Onset CRC Is Increasing Equally

In the past, colorectal cancer was thought to be an aging illness. However, a growing number of individuals under 50 are receiving diagnoses these days, frequently with severe stages of the disease rather than mild or easily curable versions. The number of CRC cases in those under 50 has increased by 2.2% annually during the past 20 years. The harsh reality that lies beneath this figure is that African Americans are receiving diagnoses at a younger age, later in life, and with worse consequences.

In contrast to white people, African Americans encounter:

a 20% increase in CRC incidence.

One of the lowest five-year survival rates among all racial groups.

Right-sided colon cancer, which is infamously more deadly and difficult to detect, is diagnosed more frequently.

What Causes the Differences? The Solutions Are Intricate and Immediate

Why early-onset colorectal cancer (CRC) is increasing and why certain populations are more affected than others is still a mystery to us. However, we are aware that the root cause of the discrepancy is injustice.

African Americans may be more susceptible to early-onset colorectal cancer due to a number of interrelated factors:

Communities with food deserts and restricted access to recreational areas are more likely to have high-risk dietary patterns, obesity, and inactivity.

Access to healthcare is still glaringly unequal. Early detection of colorectal cancer (CRC) depends on preventative care, early symptom assessment, and timely colonoscopies often luxuries in impoverished areas.

For a variety of causes, from systemic hurdles to healthcare bias, African Americans are less likely to undergo prescribed treatments, such as chemotherapy and surgery, after being diagnosed.

These are the results of systemic racism, generational poverty, and ingrained social disadvantage rather than just personal health habits.

Additionally, biology is involved, although science is still developing.

Biological differences might also be involved. The right colon, a part of the large intestine where malignancies are usually more aggressive and difficult to detect, is where African Americans are more prone to acquire colorectal cancer (CRC).

There may be variations in the onset and progression of cancer in African American patients, according to new research on the epigenome, the layer of chemical molecules that affect gene expression. According to preliminary research, microbial imbalances may differ by race. Similarly, the gut microbiome, the extensive ecosystem of bacteria that reside in your intestines, is being investigated as a potential cause of early-onset colorectal cancer.

However, it is important to stress that biology is never a justification for ignoring the powerful influence of economic and sociopolitical variables.

Revised Guidelines Assistance But Not Sufficient

The American Cancer Society (ACS) reduced the recommended screening age from 50 to 45 in 2018 in response to the growing prevalence of early-onset colorectal cancer. In 2020, the U.S. Preventive Services Task Force did the same. Although this is a significant advancement, it is not a comprehensive answer.

To begin with, these revised guidelines:

Do not fix the access gap; screening works only if people can afford it, take time off work, and receive care that is sensitive to their cultural background.

Risk omitting African American patients at higher risk, for whom early screening could save lives.

In actuality, the efficacy of new guidelines depends on the structures in place to distribute them fairly.

A Call to Action: Moving Toward Justice, Beyond Medicine

While improving screening methods and creating better therapies are important, they are not the only ways to address this issue. It involves facing the more difficult reality that systematic racism is a public health emergency.

We require:

education that is rooted in the community and meets people where they are, both culturally and geographically.

Medicaid expansion, better nutrition access, and financing preventative screenings in underprivileged communities are examples of policies that help bridge the care gap.

This is more than just a health problem. It is a moral one.

In summary, early-onset colorectal cancer is a symptom rather than merely a statistic.

An alarming trend is the increase of colorectal cancer with an early beginning. The racial inequalities associated with it are alarming. It is time to pay attention, take action, and support solutions that go beyond curing illness if we genuinely care about health fairness. They need to deal with its causes.

Because there is a story behind every statistic. A family. A brief life. And a system that has to be changed.