Colorectal cancer (CRC) is the second-leading cause of cancer-related death in the U.S., even though it can be successfully treated if caught early. The American Cancer Society (ACS) estimates that more than 150,000 people will be diagnosed with CRC in 2024, and the disease will be responsible for more than 53,000 deaths.
African Americans are about 20% more likely to get colorectal cancer and about 40% more likely to die from it than most other groups, according to the ACS. Its research also concludes that African Americans have the highest rates of colorectal cancer when compared to any racial/ethnic group in the US.
The FDA recently approved Guardant Health’s “Shield” blood test for colorectal cancer (CRC) screening in adults aged 45 and older who are at average risk for the disease. It is the first blood test to be approved by the FDA as a primary screening option for CRC. This is also the first blood test for CRC screening that meets the requirements for Medicare coverage.
“A colonoscopy requires a lot of work, and it can be inconvenient. A lot of people are afraid to move on that, so they would prefer to do some non-invasive tests to see if colon cancer can be detected early. I’m for anything that will make people move in the direction of getting their colon checked out,”
Dr. Joel Riley, a SSM Health Medical Group gastroenterologist
“The interesting things about African Americans with colon cancer are that they have the lowest survival rate when they’re detected, they’re usually more advanced when [detected], and they’re more likely to get it at a younger age,” Dr. Joel Riley, a gastroenterologist at SSM Health Medical Group, said.
“They’re not as responsive to the chemotherapy if it’s an advanced disease, so there’s a difference in treating some African American patients compared to the white populations.”
According to the gastroenterologist, the early onset of colon cancer is also disproportionately affecting the African American population, for which the causes are being researched.
“I’ve seen some very alarming and shocking cases of some young people with colorectal cancer. Chadwick Boseman, [he was] 43, you know. He’s a young cat who was in several great films, and I don’t believe he had a family history of colon cancer. But that’s what he had, so we’re seeing it a lot,” Riley said.
Riley emphasizes the importance of colon cancer screenings, which can aid with early detection and improve the survival rates.
“Colon cancer is a problem, particularly among African Americans, but for all people, and we’re starting to see it at a younger age,” Riley said.
“We used to screen at 50, but now we’re down to 45, so any time we can try to prevent things from happening, that’d be great.”
When colorectal cancer is found at an early stage before it has spread, the five-year relative survival rate is about 90%, according to the ACS.
“Colon cancer is a disease that you want to catch early, and a colonoscopy is the gold standard to see if we find something in the colon,” Riley said.
According to the gastroenterologist, a colonoscopy typically requires the patient to take a day off work, drink bowl prep, and come into the office where they are sedated for the invasive procedure.
“A colonoscopy requires a lot of work, and it can be inconvenient. A lot of people are afraid to move on that, so they would prefer to do some non-invasive tests to see if colon cancer can be detected early. I’m for anything that will make people move in the direction of getting their colon checked out,” Riley said.
According to Guardant’s website, Medicare Part B (Medical Insurance) covers a blood-based biomarker screening test to check for colorectal cancer if the individual is between the ages of 45–85, shows no symptoms of colorectal disease, and is at average risk for developing colorectal cancer.
“Our hesitation to screen our younger populations, particularly the African American population, has decreased because most of the time when they do seek medical care, particularly if they have seen several doctors before the diagnosis is made, there may be significant precancerous polyps or colon cancer,” Riley said.
“We are more attentive to our younger population with the possibilities of developing colon cancer by listening to their alarm signals like bleeding or loss of weight or pain.”
Screenings should also be sooner for those with a family history and people with a history of colon cancer and irritable bowel disease.
More than three out of four individuals who die from colorectal cancer (CRC) are not up to date with their screening. Colon cancer is found at an early stage before it has spread, the five-year relative survival rate is 91%. If the cancer has spread to distant parts of the body, the five-year relative survival rate is 14%.
“The persistent gap in colorectal cancer screening rates shows that the existing screening options do not appeal to millions of people,” said Daniel Chung, MD, a gastroenterologist at Massachusetts General Hospital and professor of medicine at Harvard Medical School.
The CRC screening rate in the U.S. is only about 59%, which falls well below the National Colorectal Cancer Roundtable’s goal of 80% for eligible individuals.
“The FDA’s approval of the Shield blood test marks a tremendous leap forward, offering a compelling new solution to close this gap,” Chung said in a statement.
“This decision will help make screening tests more broadly accessible and propel blood-based testing and CRC screening into a new era; with increased screening rates and early cancer detection, many more lives can be saved.”