I recently had a colonoscopy, readers. Now if you’ve never had one, well, to say that it’s an interesting experience would put it mildly. Although not by any stretch of the imagination one of the most pleasant of my experiences in life, I’m happy to report that in the, eh, “end,” my results were positive.
However, I was unnerved later that day when I read an article and saw the statistics relating to Black men and colorectal cancer. Of course, that was of immediate interest to me. But before I get to those statistics I’ll start with a recent “conversation” I had with my colon after my colonoscopy
COLON: Well, well, well, look who’s back. I started to worry about you when I heard about the talented actor Chadwick Boseman who starred in Black Panther and other films who died at the early age of 43 from colon cancer. I was praying that you didn’t suffer the same fate. So, what brought you here Terry?
ME: Well, when my primary care physician asked me when the last time was when I had a colonoscopy I couldn’t remember. He told me to get one.
COLON: Oh, I see. Okay since those of us in the Black colon community don’t get out much, except for an occasional autopsy, what else has been going on out there?
ME: Well, let’s see. Among lots of things, since my last visit with you a COVOD-19 pandemic swept our nation and resulted in the deaths of over a million Americans. In addition, we experienced an insurrection on January 6, 2021, when Donald Trump tried to overthrow the results of the election. And recently Labron James got traded to the 76ers.
COLON: What else?
ME: Are you familiar with the name Robert F. Kennedy, Jr.?
COLON: Yes, somewhat. Why do you ask?
ME: Well, he’s now the United States Secretary of health and human services, a conspiracy theorist and anti-vaccine activist. Can you believe it?
COLON: Wow, that’s worrisome, especially since we’ve heard about the outbreak of measles. Okay you must now get ready for your procedure, so drop your undies because the doctor who’ll administer your procedure is in the building and she likes to begin on time.
ME: She? Oh my, I’ve never had a female do this. I’d be embarrassed for her to see that part of me. Can you put me under?
So here we are readers; colonoscopies, cancer and men – Black men in particular!
Now to begin, years ago right after my last colonoscopy, I published a tongue in cheek hyperbole, “A talk with my colon,” like the one above. My aim was to humanize that experience with some self-directed humor. But when I came across recent sobering statistics relating to colon cancer and Black men, I administered myself a well-deserved slap upside my head, “C’mon dude, get serious about a serious issue,” an epiphany that shook me to the core. Here it is:
Black men face a higher risk of getting and dying from colorectal cancer compared to other groups. In fact, Black individuals have about a 20% higher chance of developing colorectal cancer and a 40% higher chance of dying from it.
Wow, 20%!…40%! Let those two percentages sink in for a moment. Repeat them. Memorize them. Jot them down someplace.
Let’s now move on with some background and context..
Research reveals that lower rates of colonoscopies among Black men are driven by a combination of systemic barriers, medical mistrust and cultural factors. These hurdles include the lack of healthcare access, lower provider recommendation rates, fears surrounding the procedure and historical and ongoing systemic racism in medicine. Here’s a deeper dive into each one of those factors followed by my take on each:
- Healthcare Access: Disparities in health insurance, lower socioeconomic status, and living in areas without nearby gastrointestinal specialists reduce screening opportunities.
My take: With Project 2025 and GOP threats to provide deep cuts in social programs like Medicaid, disparities are certain to widen.
- Provider Bias: Doctors are less likely to recommend screenings if they assume a patient is uninsured, underinsured or unable to afford follow-up care.
My take: Research has time and time again confirmed that implicit biases continue to exist even in medical delivery when decisions are made at the unconscious level.
- Quality of Care: Black individuals often receive care at under-resourced facilities with lower screening and detection standards.
My take: The unconvinced individual can simply drive through areas that are highly concentrated with people of color to observe under-resourced local facilities.
- Medical Mistrust: Historical abuse and modern systemic inequities in the medical system breed a deep, rational mistrust of healthcare providers and recommendations.
My take: Like how many recall the movie “Remember the titans” starring superstar actor Denzell Washington, many Black folks remember the Tuskegee Experiment, a 40-year observational study from 1932 to 1972 when the U.S. Public Health Service tracked 600 low-income Black sharecroppers in Alabama—399 with untreated syphilis and 201 healthy controls. Researchers deceived participants, withheld penicillin cures, and caused preventable deaths. Fast forward to the outbreak of COVID-19 where we saw more evidence of vaccine distrust attributable in part to memories of the Tuskegee Experiment.
- Perceptions of Masculinity: Concerns regarding bodily vulnerability, sedation, and the perceived sexualized or invasive nature of rectal exams create psychological resistance.
My take: Truth is that the increase in the number of qualified women providing nursing care and administering colonoscopies may increase anxieties by men who dread running into one of those women at a local Walmart who, with a wry grin could greet you with a, “Hey Terry, it’s nice to ‘see’ you again.”
- Lack of Symptoms: Many men skip preventative screenings because they feel healthy, not realizing that precancerous polyps cause no early warning signs.
My take: Recently I told a good friend about my upcoming colonoscopy and asked whether he’d had or planned to have one. “Nope, I’m good my brother. I’m in great shape and never had one and never will.”
So, in closing and in departing all my male brethren – Black men in particular – I offer you a two-sided coin to think about as I take you back to the two percentages…20% and 40%… you took note of at the outset. Imagine on side one the 20% and 40% percentages etched in. And on the opposite side are the 80% and 60% percentages, respectively, the odds that because you acted your chances of not developing and dying from colon cancer are pretty darn good.
Then ask yourself this: “Am I willing to risk the rest of my life and the well-being of those who depend on me on the flip of a coin?”
Yes? ….No?
Terry Howard is an award-winning writer, a contributing writer with the Chattanooga News Chronicle, The American Diversity Report, The Douglas County Sentinel, TheBlackmarket.com, recipient of the Dr. Martin Luther King, Jr. Leadership Award, and third place winner of the Georgia Press Award.
