Last week, the death of Hollywood actor Chadwick Boseman sent shock waves through the world of entertainment. The beloved star of ‘Black Panther’ died from colon cancer on Friday at the young age of 43. The supremely talented Boseman, who also portrayed James Brown in the biopic ‘Get On Up,’ and Thurgood Marshall in the eponymous ‘Marshall,’ succeeded in keeping his illness private until his passing. He had been diagnosed with stage III colon cancer back in 2016, and battled on as it progressed to stage IV, according to his Twitter account.
— Chadwick Boseman (@chadwickboseman) August 29, 2020
Boseman’s death underscores a troubling racial disparity – colon cancer kills African Americans at a higher rate than any other race in America.
According to the American Cancer Society, colorectal cancer (CRC) is the third most common cancer among African Americans – with close to 20,000 Black people diagnosed in 2019 alone. CRC also killed approximately 7,100 Blacks in 2019, representing 10% of all deaths among the population.
The American Society For Gastrointestinal Endoscopy notes that both the diagnosis and death rates from CRC are higher among African Americans than any other population in the United States. In fact, while the overall rate of mortality for CRC has dropped since the early 2000s, the mortality rate remains appreciably higher for Blacks juxtaposed white counterparts.
“African-Americans are more likely to get colon cancer, they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer, they’re more likely to die from colon cancer and they have shorter survival after diagnosis with colon cancer,” stated Dr. Fola May, assistant professor of medicine at UCLA and a researcher at Cedars-Sinai Medical Center via a KCRW interview.
But why?
One big factor for the disparity in CRC deaths – and cancer deaths in general among Blacks – is socioeconomic. Research shows that screening, particularly colonoscopy, is linked with reduced risk of dying from CRC. A study which appeared in JAMA found that African Americans and people of low socioeconomic status have the lowest rates of CRC screening. Lower screening rates equate to greater odds of the disease being diagnosed in late stage.
Another problem, and perhaps more pertinent to Boseman (although the details of his cancer are unknown), appears to be genetic related and location based. That is, Blacks are more likely to develop a cancerous growth on the right side of their colon – which is relevant because flexible sigmoidoscopy, a procedure often used to screen for CRC – only allows physicians to identify tumors on the left side. The reason for this, according to a study conducted by Cleveland Clinic, may be attributable to unusually early mutations in the BRAF gene in Blacks, which is associated with the development of right-sided tumors.
The augmented risk of CRC diagnosis and death in African Americans has lead to changes in screening recommendations in this population. Black people are urged to undergo colonscopic screening at the age of 45. What’s troubling is, Blacks also have a lower rate of screening compliance, which makes it imperative to emphasize preventative cancer measures, and improve access to such.
Chadwick Boseman, who rose to fame playing T’Challa, the regal king of Wakanda, is proof that even royalty is not immune to the devastating, and merciless killer that is cancer.
Get screened.
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