Breaking Barriers: Addressing Colorectal Cancer in Different Communities

Colorectal cancer affects everyone, regardless of gender, sexuality, nationality, or ethnic background.

The impact, however, isn’t the same across every community. There are unique challenges and disparities that impact communities from getting the care they need. Understanding these factors can help promote better health and ensure everyone receives the care they need. Here’s how colorectal cancer (CRC) affects different communities and what barriers they face in accessing crucial screening and treatment.

Black and African Americans

Barriers to Screening

  • Fear and Misinformation: Fear of the procedure (62%) and results (54%), and a belief that screening isn’t necessary (48%) are the biggest barriers among Black Americans surveyed
  • Access and Quality: Inequities in healthcare access and quality of screening and treatment, not genetic differences, drive these disparities

Cultural and Socioeconomic Factors: Mistrust of the medical community, higher burden of cancer risk factors (diet, exercise, obesity, and underlying health conditions), low income, lack of transportation and health insurance, and discrimination within healthcare settings

Higher Risks and Mortality

Since the early 1990s, Black individuals have faced higher rates of colorectal cancer and mortality compared to other racial and ethnic groups. They are:

  • 20% more likely to get CRC 
  • 40% more likely to die

Challenges and Disparities

  • More likely to be diagnosed with CRC under the age of 50
  • Often present with late-stage disease
  • Higher five-year mortality rate post-diagnosis

Asian Americans

Barriers to Screening

  • Cultural Barriers: Fear of diagnosis, modesty, reliance on Eastern Medicine, and a focus on treating symptoms rather than prevention

Logistical Barriers: Lack of information in native languages, difficulty navigating the healthcare system, and fear of screening procedures

Rising Risks

Asian Americans, the fastest-growing minority group in the United States, face increasing CRC risks, especially after immigration

  • 52% of Asian American adults between 50-75 have not been screened for colorectal cancer
  • CRC is the 2nd most common cancer among Asian Americans

Hispanics

Barriers to Screening:

  • Logistical and Financial: Lack of knowledge and resources, low income, and lack of health insurance
  • Cultural Barriers: Misconceptions about Western medicine, language barriers, fear of cancer and procedures, cultural taboos around discussing disease and death, and prioritizing family health over personal health

Screening Gaps

Hispanic and Latino Americans have the lowest colorectal cancer screening rate among U.S. racial and ethnic groups and are more likely to delay getting screened for CRC compared to other groups.

  • Only 49% of eligible Hispanic adults get screened, compared to 58% of non-Hispanic whites
  • Screening rates vary widely within the Hispanic community, from 55% of Mexican descent adults to 76% among Puerto Rican adults

 

as defined by the U.S. Census Bureau. Lower screening rates often lead to later diagnoses, advanced cancer stages and poorer treatment outcomes.

American Indians and Alaska Natives

Barriers to Screening

  • Geographic Isolation: Living in rural and isolated communities limits access to screening
  • Risk Factors: High rates of tobacco and alcohol use, diets high in animal fats and low in fresh produce, inactivity, obesity, and diabetes

Individual and Community Barriers: Limited awareness of cancer risks, mistrust of the medical community, fear of screening, lack of funding for tribal health clinics, high poverty rates, and limited preventive care programs

Critical Concerns

American Indians and Alaska Natives (AI/AN) people have the highest incidence of any population for colorectal cancer.

  • Less than half are up-to-date with CRC screening
  • Alaska Natives have the highest CRC incidence in the world, double or more than other racial groups

LGBTQIA+

The LGBTQIA+ community faces unique challenges and barriers when it comes to accessing healthcare, including essential screenings like those for colorectal cancer. Discrimination, stigma, and systemic inequalities within the healthcare system often deter LGBTQIA+ individuals from seeking the care they need. This can lead to delays in diagnosis and treatment.

Barriers to Screening

  • Discrimination: Biases within the healthcare system can lead to inadequate care for LGBTQIA+ individuals. These biases might manifest as legal discrimination, lack of inclusive social programs, or simply a shortage of culturally competent healthcare providers.

Healthcare Access: The combined effects of sexual and transgender stigma, racism, and xenophobia further exacerbate healthcare access issues for LGBTQIA+ people, particularly those who also have limited English proficiency.

Overcoming Barriers

  • Finding Affirming Healthcare Providers: Seek out healthcare providers who are knowledgeable about and sensitive to LGBTQIA+ issues. Providers that practice cultural humility can make a significant difference in ensuring that LGBTQIA+ individuals receive the screenings and treatments they need.
  • Education, Research, and Advocacy: Educating healthcare professionals about the specific barriers faced by LGBTQIA+ patients is important in improving health outcomes. Education and research should include understanding the impact of discrimination, the importance of inclusive care, and the unique health risks faced by the LGBTQIA+ community.

Critical Concerns

LGBTQIA+ people face large barriers to primary care as well as cancer screenings, including finding welcoming providers who are understanding of their specific needs.

  • Mental Health: Higher rates of stress, anxiety, and depression within the LGBTQIA+ community can impact overall health, potentially increasing the risk of various conditions, including cancer.

Lifestyle Factors: Rates of smoking, alcohol use, and obesity can be higher among LGBTQIA+ Individuals due to social and cultural factors, all of which are known risk factors for colon cancer

Understanding these health disparities and barriers to screening is the first step in addressing the inequities in colorectal cancer prevention and treatment. By spreading awareness and advocating for better access to screening and healthcare for all, we can work towards a future where everyone has an equitable opportunity to detect and treat colorectal cancer early. Share this information with your friends and family to help raise awareness! If you’re over 45 or have a family history of CRC, talk to your doctor about screening options.