Colorectal Cancer Occurring Earlier

by Darrell L. Taylor

From PHN Issue 34, Fall 2017

In the New York State Department of Corrections and Community Supervision (DOCCS), inmates are not screened for colorectal cancer until the age of 50, regardless of what ethnic group one may belong to. It has been established that people of African origin are at higher risk than other ethnic groups and therefore should be screened at an earlier age, especially if there is a family history. Finding and removing polyps on the inner wall of the colon or rectum can prevent colorectal cancer.

For decades, colorectal cancer has been considered a disease of advancing age. Most diagnoses are among people in their 60s and 70s, according to the Centers for Disease Control and Prevention.

However, a recent study in the Journal of the National Cancer Institute reported a different trend among younger people. Over the past few decades, Generation X and Millennials have seen a steady increase in colon and rectal cancer, with 3 in 10 new rectal cancer patients younger than 55. Medscape Medical News reported a study finding that 1 in 7 diagnoses of colorectal cancer are now in people younger than 50.

Dr. Marcus Noel, who specializes in gastrointestinal cancers, told USA Today, “Many of these cases are not being caught at an early stage, and so we’re seeing young patients that are dying from this disease. If the trend continues, we’ll see an increase in death rate in younger people from this disease.”

The American College of Gastroenterology Colorectal Cancer Screening guideline recommends screening in African Americans beginning at age 45 years.

I’m a 46-year-old of West African roots. I’ve been incarcerated since July 22, 2003, approximately 14 years. I was made aware of colon cancer at an early age because my uncle (maternal) succumbed to it, by not getting a diagnosis in time. When I learned that people of African descent were at higher risk than other ethnic groups, and the minimum age to get screened was 45, I knew I would initiate getting screened when I turned 45. Then I learned that the DOCCS inmates are supposed to be screened at age 50, regardless of ethnic group. This is essentially dangerous for the inmate population of African descent, regardless of gender.

When I turned 45, I was at Wende Correctional Facility, where I took the initiative to get it done. My grounds for getting it done were my family history and my awareness of my well-being. I met and spoke with the nurse practitioner there, who initially attempted to dismiss me with the “Not till 50” spiel. Then she heard my reason and scheduled an appointment at the Erie County Medical Center (ECMC) in Buffalo, New York to have a colonoscopy procedure.

I went through the prep in the facility’s medical unit for two days before the procedure. After the prep, I was taken to ECMC, and the procedure was performed in 19 minutes. The findings were a 1 cm sessile polyp, which was completely removed using hot snare. After I regained consciousness, I was told the results and felt relieved and thankful to my higher self for getting the procedure done. When I had the follow-up a month later, I met with the doctor who performed the procedure. She explained to me that the polyp was “pre-cancerous,” and had I not gotten the colonoscopy done when I did, it could have developed in another five years. That five years would put me at 50 years old, which is when the DOCCS medical staff does screening. I am free of what could have potentially been a very dangerous situation.

The doctor who performed the procedure recommended that I be afforded a high-fiber diet as well as repeat flexible sigmoidoscopy in 6 months to evaluate the site where the polyp was located.

Of course, this being the Department of inadequate medical care, I have not been afforded the high-fiber diet, because my health care provider said I looked healthy enough. It has been 7 months since the doctor made that recommendation.

If you are 45 or older and of African descent, it would be wise to initiate a conversation with your doctor and make preparations to get the procedure done. There are non-invasive tests, such as stool samples. If you have a family history of colorectal cancer and are from any of the Human Families, you should definitely want to know your status, as we are all from the same source.

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