Guest blog written by Dr. Charles R. Rogers, behavioral scientist and master certified health education specialist (MCHES®). Dr. Rogers’ research agenda has contributed to translational solutions that address the complex underpinnings of inequalities in men’s health, with a primary focus on colorectal cancer (CRC) awareness and prevention among African-American men for more than 10 years. His research foci also include cancer health disparities, behavioral & community-based implementation science, mixed methods, and survey methodology. Dr. Rogers’ capabilities and potential have been recognized locally and nationally by the receipt of several competitive scholarships, grant awards, and fellowships aimed at strengthening his knowledge and skills for a life-long career in health equity research. For instance, Dr. Rogers was awarded nearly $900K from the National Cancer Institute in 2018 for his #CuttingCRC study focused on developing a barbershop-based intervention on masculinity barriers to medical care and CRC screening completion among African-American men in Minnesota, Ohio, and Utah using a mixed methods approach (K01CA234319). Since he is passionate about paying it forward, Dr. Rogers has also received a number of honors acknowledging his servant leadership (e.g., 100 Most Influential Black Alumni at NC State University).
Other health advocates and I often coin colorectal cancer (CRC) as the disease no one has to die from. With early detection screening, CRC is preventable, treatable, and beatable. Unfortunately, CRC remains the second leading cause of cancer-related death for men and women in the U.S., with African Americans bearing the greatest burden. African-American men specifically have had the highest death rates and chances of getting it among all racial and ethnic groups for both genders for more than 10 years consecutively (my entire CRC health disparities career).
In general, let’s consider the facts that among African-American men:
- 47% are more likely than White men to die from CRC;
- > 24% are more likely to get CRC compared to White men; and
- they are diagnosed younger and at more severe stages than other populations.
As I noted 6 years ago, “there are a number of reasons for the CRC-related health disparities across the nation. Most troubling is the deep distrust of the medical community, especially among African-American and Native American communities. Other issues among African-American men [I have confirmed extensively with my research] include the lack of health insurance, masculinity barriers to medical care, discrimination, poor patient-provider communication, lower socioeconomic status, and a lack of timely diagnosis and treatment.
When considering diagnosis, the United State Preventive Services Task Force (USPSTF) initially recommend age 50 for those with average risk in 1996—with a B grade, followed by an A grade recommendation of age 50 in 2002, two years after the American College of Gastroenterology set the age 50 tone in 2000.
In 2008, ACG recommended the screening be lowered to age 45 for African Americans for this preventable disease as we were presenting with CRC at earlier ages and at more advanced stages. This recommendation was essentially ignored until 2018 when the American Cancer Society (ACS) recommended the screening age to be 45 among everyone.
ACS’s recommendation is informed by the fact that by 2030, the chance of getting CRC in the United States is expected to increase:
- 90%-124% among Americans aged 20-34, and
- 28%-46% among those aged 35-49.
Today, in 2020, 12 years since ACG made the age 45 recommendation for African Americans, the ACS, Centers for Disease Control and Prevention (CDC), and USPSTF are not on the same page, so many individuals continue to die from CRC or struggle to survive as most insurance companies do not honor their early diagnoses.
Lowering the screening age for all—African-American men included—will literally save thousands of lives. It is a simple act, one well supported by research that would also reduce healthcare costs immensely. I know it is worth it. When will others agree?
Regardless, let’s all do our part to honor Chadwick Boseman’s memory and get screened or encourage our family members do so. The Black Panther became a superhero on and off the screen to all of us on Friday, August 28, 2020, when we learn he passed away from CRC. May his powerful story slowly unfolding more and more each day remind each of us to make the call or send that text to those close to us who cross our mind. We never know what people are fighting…
Thank you brother #ChadwickBoseman for sharing your passions, expressing your art, mastering your craft, lifting your voice, & elevating the representation of the Black community. We will fight on for you and your legacy. Rest in power.