Non-white Washingtonians lack screening access, die earlier of colorectal cancer

Those who live farther from endoscopy testing centers are more likely to die prematurely from colorectal cancer, and the risk is even greater for racial and ethnic minorities, according to a study from the Washington State University Elson S. Floyd College of Medicine.

Colorectal cancer is one of the most common cancers in the U.S., but also one of the most preventable if detected early, making access to screening services like colonoscopies vital.

Published in the American Journal of Surgery, the study of more than 7,000 Washington residents who died of colorectal cancer between 2011 and 2018 found that non-white residents, including Hispanic or Latinx, Black, American Indian, and Alaska Native residents, had on average less access to screening services and died earlier from colorectal cancer compared to white residents.

These factors compounded to produce a staggering eight-year life expectancy gap between non-white residents who lived far from screening services and white residents who lived closer.

"These findings are a call to action," said Dr. Anjali Kumar, senior author and vice chair of Surgery at the WSU College of Medicine. "As a practicing colorectal surgeon and endoscopist, I can't just see a disparity like this and be okay with it."

More than twice as many white residents lived within 6.2 miles of screening services compared to non-white patients, the study discovered, which is a distance prior research found impacts cancer outcomes.

Residents who lived more than 6.2 miles away from screening services were significantly more likely to die prematurely of colorectal cancer, but this increase didn't affect groups equally. White residents died an average of 1.6 years earlier if they lived far from services, while non-white residents died 6.9 years earlier on average.

"We know that there are racial disparities in health care outcomes, but seeing the difference in the sheer number of years was surprising," said lead study author Dr. Ashley Edwards, who conducted this research as a WSU medical student.

The researchers also collaborated with Ofer Amram, associate professor and director of the Community Health and Spatial Epidemiology Lab at the WSU College of Medicine, to create a heat map that compares endoscopy center locations with residents' home addresses at time of death from colorectal cancer.

This spatial epidemiology analysis showed concentrations of premature mortality far from screening services among non-white residents in areas with large Hispanic or Latinx farmworkers and Indigenous populations, including the Yakama Nation, Puyallup Tribe, and the Tulalip Tribes.

Spurred by the study's findings, the researchers plan to collaborate with communities in Southeast Washington to design interventions to improve awareness of screening options and increase their use. Their goal is to catch more cases before they develop into colorectal cancer.

Geographic distance isn't the only barrier to colorectal cancer screening, which is recommended to start at age 45. Other hurdles include lack of transportation, inadequate insurance, and lack of paid time off for procedures like a colonoscopy, which is a type of endoscopy. To address that, the researchers see potential in mobile health units to bring services to work sites and provide access to non-invasive options like stool-based screenings and emerging biomarker blood tests.

Study authors also included then-WSU medical student Dr. Rachel Monroe. Dr. Edwards won first prize for the research at the 2022 meeting of the Northwest Society of Colon and Rectal Surgeons and first prize at an international meeting of the North Pacific Surgical Association in 2023.

Media Contacts

• Stephanie Engle, WSU Elson S. Floyd College of Medicine Communications and Marketing, 509-368-6937, [email protected]

Public link

Please use the above public link if you want to share this noodl on another website.