Closing the colon cancer mortality gap between Black communities and white populations

Dr. Chyke Doubeni believes he has answers to closing the colon cancer mortality gap between Black communities and white populations.

“They’re actually surprisingly simple,” says Doubeni, an epidemiologist and health services researcher who heads the Mayo Clinic’s Center for Health Equity and Community Engagement Research, which works out of Rochester and other Mayo facilities.

In fact, one health clinic in south Minneapolis already has assembled a successful track record of closing those gaps with culturally responsive care.

But first, the disparities. According to Doubeni’s research, across the United States, the colon cancer mortality rate for Black men stands at 21.3 deaths per 100,000 people, compared to a death rate of 15.5 per 100,000 white men.

One disparity in Minnesota is clear: People of color get screened for colon cancer much less often than the state’s white population. A report released in May 2021 from the nonprofit health-care research group MN Community Measurement found 75 percent of white adults between the ages of 50 and 75 were up to date on colon cancer screening, compared to 59 percent of Black adults in that age group.

One of the report’s findings suggests an even bigger disparity in East African communities: Just 34 percent of adults who prefer to speak Somali as a primary language were up to date on their colon cancer screening. (Similarly, 35 percent of adults in the same age group who listed Somalia as their country of origin were up to date on screening.)

Doubeni cites “the social determinants of health” as the main reason for these disparities. He lists a few examples to make his point: lack of access to cancer screening, lack of access to early cancer diagnosis, lack of access to treatment, lack of transportation to get to the treatment.

Being overweight, obese, or eating a poor diet can increase the risk of colon cancer, Doubeni added, and all of these conditions are “strongly correlated with socioeconomic status.”

So what, then, are those “surprisingly simple” answers to closing disparities that Doubeni mentioned? For starters, he says, everyone needs to have easy access to cheap colon cancer screening.

“How do you do that?” Doubeni asked. “Engage with the community to understand what the barriers are.”

One of the biggest barriers to colon cancer screening and treatment is a lack of health insurance and underinsurance, he said. Public insurance programs like Medicaid and Medicare don’t always reimburse for cancer treatment as well as private insurance does, he added.

“What the insurance company pays is sometimes the determinant of whether or not you’re going to die,” Doubeni said. “Why should that be, in this country?”

Excerpted from the originally published article in Sahan Journal