African American women urged to confront colorectal cancer

Mar 17 2006

Despite having the greatest risk of developing and dying from colorectal cancer (CRC) of any gender, race or ethnicity, an astounding 96 percent of African American women do not consider themselves to be at high risk for the disease, according to a new Harris poll.

This alarming misperception has resulted in deadly inaction, with 70 percent of African American women over the age of 45 not getting potentially life-saving screenings for CRC. One year after the American College of Gastroenterology (ACG) issued updated guidelines for African Americans to begin earlier CRC screenings at age 45, African American women have not gotten the message.

Responding to this significant health threat, the Black Women's Health Imperative (Imperative) and the National Women's Health Resource Center (NWHRC) have joined forces to launch African American Women Dare to be Aware. An educational initiative designed to uniquely address the needs of African American women, the African American Women Dare to Be Aware initiative confronts the issues preventing African American women from getting screened and seeking treatment by daring them to recognize their heightened risk and take action.

"Colorectal cancer is not color blind and it has a penchant for African American women," said Lorraine Cole, president and CEO of the Imperative. "Our mission is to let every African American woman in this country know why it's so critical for them to get screened early. We're also giving them tools to help them take action against this deadly but beatable disease," added Elizabeth Battaglino Cahill, RN, executive director, NWHRC.

Many African American women are not aware of the benefits of early detection. In fact, if colorectal cancer is detected while still in the localized stage, the five-year survival rate in all African Americans is 83 percent. However, according to the survey, a mere six percent of women over 45 discussed CRC the last time they saw their health care provider, because they didn't think they were at particular risk (27%), their doctor didn't bring it up (15%) or they didn't think there was a reason to (16%).

Many theories -- some supported by research -- attempt to explain the disparity in screening habits for African Americans, ranging from health care access, to socioeconomic factors, to cultural beliefs, to inadequate patient education. Fear and lack of awareness of their heightened risk surfaced as major obstacles to screening for survey respondents; most African American women over age 40 would be more likely to get screened for cancer if they believed they were at risk (94%); if they had symptoms (95%) -- which do not present until the disease is advanced; if they were not afraid to find out the results (70%); if the tests were not so unpleasant (71%); and if the side effects of cancer treatment were not so bad (73%). Yet only 36 percent of respondents are even aware of treatment options including oral chemotherapy, which may have less severe side effects than intravenous therapy.

"African American women face many barriers to screening, detection and treatment of colorectal cancer, but getting beyond our own fear and learning the facts can go a long way in improving our survival and quality of life," said Dr. Edith Mitchell, clinical professor of medicine and program leader in gastrointestinal oncology, Thomas Jefferson University. "Colorectal cancer is not a death sentence, so don't let that stop you from asking your health care provider about screening and, if colon cancer is found, treatment. Colorectal cancer is not only treatable but beatable."

When screening reveals the presence of colorectal cancer, there are viable treatment options available depending on the stage of the disease, including surgery, chemotherapy, monoclonal antibodies, and radiation. The field of colorectal cancer therapy continues to advance, and chemotherapy drugs, including oral chemotherapy, have been effective in eradicating and shrinking tumors and delaying tumor growth. Oral chemotherapy, in particular, is an option that may help some patients continue going to work or spending time with family and friends because they are spending less time in the clinic for treatment.

African American women need to learn about their heightened risk for CRC and take steps to prevent or detect it. African American Women Dare to Be Aware provides critical information and tools to help women take action, including fact sheets; important CRC questions answered by an African American oncologist; a risk assessment tool; an African American colorectal cancer survivor's story; an educational brochure; and a list of important colorectal cancer resources. Please visit the Imperative's Web site at http://www.blackwomenshealth.org/ and the NWHRC Web site at http://www.healthywomen.org/ to access any of these materials.

African American Women Dare to Be Aware is a continuation of NWHRC's Dare to Be Aware program, which is designed to empower all women to take control, face their fears and fight against a disease that is indeed treatable and beatable if diagnosed early.