28 Mar, 2023
Let’s end colorectal cancer disparities, reduce deaths by increasing screening
Martha Wofford is president and CEO of Blue Cross & Blue Shield of Rhode Island.
I never knew my father’s mother. Colon cancer took her life at only 62, before I and my siblings were born.
After she had several miscarriages in Tennessee, she and my grandfather were determined to access better healthcare – traveling to New York City, where more modern care enabled her to conceive three children. Their focus on accessing good care, however, could not help her avoid what is a highly preventable cancer today. Sadly, she died of colon cancer in 1961, eight years before the colonoscopy was developed.
As we stand here in 2023 during Colorectal Cancer Awareness Month, we are fortunate to have better tools than ever to drive detection of this cancer. Yet according to the American Cancer Society (ACS), colorectal cancer remains the second most common cause of cancer deaths for men and women combined, with more than 52,000 deaths expected this year. Significant and unacceptable racial and ethnic disparities persist, with Black Americans about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups. And now we are seeing a new and troubling trend—a steady increase in Americans under 55 being diagnosed with colorectal cancer, comprising 20% of all cases in the country according to a new ACS report.
Although colorectal cancer can be deadly, it is highly preventable and treatable. Unlike most cancers, colorectal cancer can be detected early through a variety of screenings, allowing for the removal of precancerous polyps and effective treatment of early-stage cancer.
We have made a great deal of progress. U.S. death rates from colorectal cancer have declined more than 50 percent over the last 30 years. In Rhode Island, we are working collaboratively to further reduce these numbers. Kudos to the Rhode Island Department of Health, local hospitals, community health centers, and gastroenterology practices for continuing to coordinate free screenings for Rhode Islanders who lack insurance.
For those with health insurance, screenings are now completely covered in Rhode Island. We applaud Governor McKee, Senator Maryellen Goodwin, and Representative Mia Ackerman for their leadership in 2021, passing the “Maryellen Goodwin Colorectal Cancer Screening Act" mandating that insurers cover all examination and laboratory costs.
At Blue Cross & Blue Shield of Rhode Island, in addition to playing our insurance role, we are working to raise awareness to get all Rhode Islanders screened as part of our efforts to improve health equity. We have just mounted a campaign to ensure 80% of our members ages 45 to 75 are regularly screened by 2026. We’re now at 71%. That may not sound like a significant increase, but if you dig deeper into our data, you see that the screening rate for whites is 76%, while it’s just 69% for Blacks and 68% for Hispanics. So we have an additional, critical goal to reduce these disparities by at least 50 percent.
We recognize that colonoscopies, while the gold standard for screening, just aren’t the best option for everyone. That’s especially true for some of the underserved populations we are trying to reach, who often can’t take time off from work or caring for family to prep for, and undergo, a colonoscopy. We are collaborating with the Lifespan Community Health Institute and other partners on educating people about all screening options—including at-home kits—and navigating them to the tests that are most appropriate for them.
We are also using all our means of communication to raise awareness about the need to get screened, including through our trained staff working in Your Blue Stores and traveling around the state in Your Blue Bus.
We expect our health equity data and our ability to address disparities will only become more impactful with our just-launched effort to invite members to provide more information about their race, ethnicity, language, sexual orientation, and gender identity.
There are many cancers and medical conditions that we struggle to detect, but we have the tools to fight colorectal cancer. We can’t let decades-long racial and ethnic disparities in healthcare prevent all Rhode Islanders from accessing lifesaving care. Please join us in spreading the word, and if you are due for a screening, please talk with your primary care provider about the best option for you. Don’t put it off!
You can also find this column in the Boston Globe.