Ugo Iroku, M.D., M.H.S.
Secretary, Co-Founder, Association of Black Gastroenterologists and Hepatologists (ABGH)
In March 2000, to reduce the stigma of the procedure, Katie Couric had a colonoscopy on live TV. She walked the millions of viewers tuning in through the entire process: the drinking of the laxative preparation; the frequent cuts for bathroom breaks; the actual test itself with the physician providing step-by-step commentary; and her post-procedure declaration: “It really didn’t hurt!”
America experienced a 20 percent increase in colorectal cancer screenings following that segment, so profound that it would be dubbed the “Katie Couric Effect” by public health researchers. Two decades later, however, there are new challenges to the screening and detection of colorectal cancer — the No. 2 most deadly cancer in America — that will require their own new bold solutions.
The pandemic dynamics
On March 1, 2020, there were less than 100 confirmed cases of the new COVID-19 pandemic nationwide. By the end of that month alone, that number would balloon to 164,000. The ensuing nationwide shelter at home orders and state directives to stop elective medical procedures led to a stark plummet in cancer detection services, with an 85-90 percent drop in colorectal cancer screenings. There are early estimates of 80,000 delayed diagnoses, which may result in thousands of excess colorectal cancer deaths.
The youth surge
In the decades leading up to 2020, colorectal cancer screening efforts effectively dropped the rates of cancer in all demographics but one: young people. Adults under the age of 50, who typically represent 12 percent of the 150,000 Americans who develop colorectal cancer annually, were found to have a 2 percent increase in cancer cases annually.
Statistical models project the number of young adults with colorectal cancer will double by the year 2030. The reason why young people are at more risk of early-onset colorectal cancer than ever before is still under investigation.
Health inequities
The larger benefits from colorectal cancer screenings are not only limited by age, but also by race and ethnicity. Black Americans are 20 percent more likely to get colorectal cancer than white Americans, and are up to 40 percent more likely to die from it. Additionally, Spanish-only speaking Hispanic Americans have the lowest rates of colorectal screening.
These new challenges demand new solutions, and some are already being considered. Campaigns welcoming patients back safely to the healthcare system for their screenings are being launched. Nationwide, new guidelines are being considered to lower the age of screening from 50 to 45 for all Americans. And many organizations, including the newly formed Association of Black Gastroenterologists and Hepatologists, are making intentional inroads with the Black community to increase awareness and access to colorectal cancer screening.
Katie Couric had a colonoscopy and changed the world. Who’s up next?
