We're Doing Something About Colorectal Cancer Disparities

“An interesting read about Colorectal Cancer disparities and what is being done about it.”
— Dr. Dale

From We're Doing Something About Colorectal Cancer Disparities  

Screening for colorectal cancer is a true public health success story. According to the most recent data from the Centers for Disease Control and Prevention (CDC), rates of screening for colorectal cancer have increased dramatically over the past two decades. That means that we are preventing more colorectal cancers and picking up many more in the earliest stages, when treatment may be more successful.

Although fewer people are being screened for colorectal cancer screening than we would like, improved screening rates are proof positive that research and outreach can and does have a big impact on people’s lives.

But there is another part of this story that is equally important but is cause for concern rather than celebration. Our progress against colorectal cancer has not been experienced equally.

African Americans, for example, have higher rates of new colorectal cancer cases and deaths than all other racial and ethnic groups. And although colorectal cancer is the fourth most common cancer overall, it’s the second most common cancer among Hispanics. Underlying these statistics, in part at least, is another well documented disparity.

Although widely accepted screening recommendations call for most people to be screened for colorectal cancer once they reach age 50, screening rates are lowest among those with lower education and income, Hispanics, American Indians/Alaska Natives, and people in rural areas. Screening rates are also low in people who are new or recent immigrants to the United States.

In short, the colorectal cancer disparities gap is significant, and the evidence that colorectal cancer screening saves lives is well documented. So we’re taking concrete steps to increase screening rates and, in so doing, alter the story line.

Earlier this year, the National Cancer Institute (NCI) launched an initiative called Screen to Save that aims to increase colorectal cancer screening rates among men and women age 50–75 from racially and ethnically diverse populations and in rural areas.

As part of this initiative, NCI-sponsored community health educators from 44 different institutions nationwide are fanning out in diverse communities across the country to educate people about the benefits of colorectal cancer screening. These educators are using evidence-based, proven strategies and tactics for motivating people who live in underserved communities to get screened.

Because we know that certain culturally-tailored outreach methods work better in specific communities and populations than in others, educators are using only those methods that have been proven to work, saving time and money. Community hospitals and clinics can incorporate these tools and techniques into their education and outreach arsenal to increase colorectal cancer screening among the communities they serve.

Effective techniques for improving screening don’t have to be fancy or expensive. For example, a recent study showed that sending text message reminders about colorectal cancer screening substantially improved screening rates in American Indian and Alaskan Native women. Another recent study showed that simply providing written information about the fecal immunohistochemical test, or FIT kit—an effective, but often overlooked, screening test for colorectal cancer—to African Americans age 50 and older increased their screening rates.

The latest data, in fact, show that, when it comes to screening for colorectal cancer, rates among African Americans have nearly caught up to the rates among White Americans. Now our challenge is to further accelerate that trend and replicate it in other populations where rates continue to lag.

NCI, CDC, and professional societies, like the American Cancer Society have supported research aimed at addressing cancer health disparities for years, and have laid the foundation for national programs such as NCI’s Screen to Save.

Moving forward, NCI and its partners―including national organizations and smaller, local nonprofits―hope to expand this program to include a larger network of hospitals and clinics that can identify people who are eligible for screening and can provide the appropriate follow-up and linkages to needed care for those who undergo screening.

This is a unique opportunity to help reduce the number of deaths from colorectal cancer. Because the best way to continue the progress we’ve made against this cancer over the past 20 years is to ensure that everybody who should be screened has the opportunity, knowledge, and resources to do so.

Grape extracts may protect against colon cancer

“A study that can change the future of colon cancer.”
— Dr. Dale

From Grape extracts may protect against colon cancer  

Colon cancer is a very common form of cancer, affecting tens of thousands of people across the United States. Researchers may have just moved closer to a prevention strategy for this condition, as a compound that suppresses colon cancer stem cells is found in grapes.

In the U.S., colorectal cancer is the third leading cause of death from cancer among women and the second in men. 

The American Cancer Society estimate that in 2017, more than 95,500 people will develop cancer of the colon, almost 40,000 people will have rectal cancer, and more than 50,000 deaths will be caused by colorectal cancer. 

A team of researchers led by Jairam K. P. Vanamala, associate professor of food sciences at the College of Agricultural Sciences at Pennsylvania State University in State College, set out to examine the effects of grape compounds on colon cancer stem cells. 

More specifically, the researchers tested the effect of a combination of resveratrol - a polyphenolic compound found in grapes, red wine, peanuts, and some berries - and grape seed extract.

As the authors write, the study rests on the theory that "most, if not all, cancerous tumors are driven by [cancer stem cells]." 

"Cancer stem cells are capable of self-renewal, cellular differentiation, and maintain their stem cell-like characteristics even after invasion and metastasis," explains lead researcher Prof. Vanamala. 

The findings were published in the journal BMC Complementary and Alternative Medicine.

Grape extracts halved cancer tumors

Prof. Vanamala and colleagues examined 52 mice with colon cancer tumors. They divided the rodents into three groups: one group was fed the grape compound combination, another group was fed sulindac (an anti-inflammatory drug previously found to reduce tumors in humans), and one group was given a normal diet.

The researchers found that the number of tumors in the mice that had the grape compound diet decreased by 50 percent. This drop was similar to the one seen in the sulindac group, but unlike the anti-inflammatory drug, the grape compounds did not cause any gastrointestinal toxicity. 

In vitro, the experiments yielded similar results, determining the "molecular basis for the beneficial effect" of the grape compounds on human cancer stem cells. 

The study also found that resveratrol and grape seed extract did not suppress cancer stem cells as effectively when taken separately and in small doses. It seems to be the combined effect of the two that produces the best results.

"The combination of resveratrol and grape seed extract is very effective at killing colon cancer cells," says Prof. Vanamala. "And [...] the combination of these compounds is not toxic to healthy cells."

Colorful diet may prevent colon cancer

Prof. Vanamala suggests that the findings may bring us closer to understanding why cultures that traditionally eat more fruits and vegetables have lower colon cancer rates. 

For instance, some studies have hypothesized that the West African diet may be the reason that Nigerians have a much lower rate of colon cancer compared with Caucasians. 

Nigeria, along with other African countries, has been shown to have the lowest cancer rates in the world. 

Plant-based diets may provide several key compounds that kill off cancer stem cells, says Prof. Vanamala. He also recommends consuming a large variety of colorful fruits and vegetables to prevent colon cancer and other chronic conditions such as type 2 diabetes. 

"This also connects well with a plant-based diet that is structured so that the person is getting a little bit of different types of plants, of different parts of the plant, and different colors of the plant.

Prof. Jairam K. P. Vanamala

He adds, "This seems to be beneficial for not only promoting bacterial diversity, but also preventing chronic diseases and eliminating the colon cancer stem cells."

However, Prof. Vanamala also adds that more work is needed to fully understand the anti-cancer mechanism behind grape compounds and other extracts in fruit and vegetables. 

The researchers hope that their findings will set the stage for human trials that could test the effects of the grape compounds on colon cancer. 

If these trials are successful, the researchers hope that the combination of resveratrol and grape seed extract could be taken in the form of a pill; this may protect against colon cancer and prevent the disease from recurring in those who survived the condition.

National Men's Health Month

“It’s time make your health a priority.”
— Dr. Dale

From National Men's Health

Take action to be healthy and safe and encourage men and boys in your life to make their health a priority. Learn about steps men can take each day to improve health.

Celebrate National Men’s Month

Get Good Sleep

Adults need between 7-9 hours of sleep. Insufficient sleep is associated with a number of chronic diseases and conditions, such as diabetes, cardiovascular disease, obesity, and depression. Also, poor sleep is responsible for motor vehicle and machinery-related accidents.

Toss out the Tobacco

It’s never too late to quit. Quitting smoking has immediate and long-term benefits. It improves your health and lowers your risk of heart disease, cancer, lung disease, and other smoking-related illnesses.
Also avoid secondhand smoke. Inhaling other people's smoke causes health problems similar to those that smokers have. Babies and kids are still growing, so the poisons in secondhand smoke hurt them more than adults.

Move More

Adults need at least 2½ hours of moderate-intensity aerobic activity every week, and muscle strengthening activities that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms) on two or more days a week. You don't have to do it all at once. Spread your activity out during the week, and break it into smaller amounts of time during the day.

Eat Healthy

Eat a variety of fruits and vegetables every day. Fruits and vegetables have many vitamins and minerals that may help protect you from chronic diseases. Limit foods and drinks high in calories, sugar, salt, fat, and alcohol.

Tame Stress

Sometimes stress can be good. However, it can be harmful when it is severe enough to make you feel overwhelmed and out of control. Take care of yourself. Avoid drugs and alcohol. Find support. Connect socially. Stay active.

Stay on Top of Your Game

See your doctor or nurse for checkups. Certain diseases and conditions may not have symptoms, so checkups help identify issues early or before they can become a problem.

Pay attention to signs and symptoms such as chest pain, shortness of breath, excessive thirst, and problems with urination. If you have these or symptoms of any kind, be sure to see your doctor or nurse. Don’t wait!

Keep track of your numbers for blood pressure, blood glucose, cholesterol, body mass index (BMI), or any others you may have. If your numbers are high or low, your doctor or nurse can explain what they mean and suggest how you can get them to a healthier range. Be sure to ask him or her what tests you need and how often you need them.

Get vaccinated. Everyone needs immunizations to stay healthy, no matter how old you are. Even if you had vaccines as a child, immunity can fade with time. Vaccine recommendations are based on a variety of factors, including age, overall health, and your medical history.