Studies in 2019 and 2020 found Latino adults are more likely to be diagnosed in later stages than white adults.
KERA’s Sam Baker talked with Dr. Roberto Rodriguez, a colorectal surgery specialist in Dallas with Texas Oncology Surgical Specialists and affiliated with Baylor Scott and White Health, about the reasons why and what can be done to improve rates of screening for the disease.
INTERVIEW HIGHLIGHTS:
Why Latinos Have A Lower Screening Rate:
I think the number one contributing factor is they're ashamed of seeking advice for changing bowel habits or for any type of symptoms. I think there's some degree of social stigma of being checked by a colorectal surgeon and they just put up with symptoms until it gets to a point that is unbearable. Unfortunately, by then, it's too late.
Number two, some limitation on resources. They may not have insurance or the resources to get a colonoscopy, see the doctor and that may be another contributing factor.
The Study Suggested Improving Access To Care Among Latinos Would Be A Major Step. Why Do You Suppose This Hasn't Happened?
I think access to care is readily available. It’s just making sure that people are aware they can get care. Again, we go back to social upbringing and cultural synchronicities that may contribute to that. We just need to make them aware that care is available and access is readily available too.
Treatment Of Late-Stage Colorectal Cancer:
A lot of advances have been made with chemotherapy agents nowadays. They're better tolerated. We see better responses to chemotherapy.
Advances in surgical technology also allow them to have their care, their surgery recover quicker.
So it's not necessarily a death sentence immediately, like it used to be years ago. I have patients with advanced stages that can live for many years, five years, even with those advanced stages.
The one thing that you have to consider with advanced ages is also the biology of the tumor. There are some tumors that are more aggressive than others. Obviously, those that are more aggressive than the life expectancy would be shorter, but in general, the common colon cancers are sort of in the middle of the road and survival even in advanced stages can be four years with appropriate treatment.
Early Detection And Symptoms
The reality is that you don't need to have any symptoms to get your colonoscopy. The current recommendation is patients, age 45 and older, should have, regardless of symptoms, a screening colonoscopy.
If they have a family member that was diagnosed with colon cancer, as a general rule, you deduct 10 years from the age of onset or diagnosis. Let's say, if you had a family member that was diagnosed with colon cancer at age 40, then first-degree relatives, 30 years and older, should be screened for colon cancer.
As for symptoms, if you have:
- Change in bowel habits
- Blood in the stool
- Abdominal pain
- Weight loss
Those things should alert you to the possibility of cancer. It's, unfortunately, a frequent occurrence that by the time you have all those symptoms, the tumor has advanced and the treatments become a little more challenging and complex.
Ways To Improve Screening Rates For Colon Cancer:
Probably number one is education and the patient’s understanding that stool tests are relatively simple and colonoscopies are very safe.
Also, the understanding that you can prevent cancer if you remove pre-malignant polyps and that colon cancer is potentially curable, if you catch it at an early stage. So, making patients aware of those issues should hopefully improve early detection.
Should Latinos Share Their Personal Experience?
No question about that. The best advocates of colon cancer prevention are actually my own patients. It's not uncommon that even young individuals who’ve had colon cancer start telling their friends and family, and it's not unusual for them to come and see me because a friend I had taken care of in the past recommended me. So most definitely, the best advocates would be colon cancer survivors or colonoscopy survivors, if you will.
RESOURCES:
Colorectal cancer screening among Hispanics/Latinos in the HCHS/SOL sociocultural ancillary study
Trends in colorectal cancer mortality in Hispanics: a SEER analysis
Cancer Facts & Figures for Hispanics & Latinos 2018-2020
Interview highlights were lightly edited for clarity.
Got a tip? Email Sam Baker at sbaker@kera.org. You can follow Sam on Twitter @srbkera.
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