Colon cancer rates drop in older Americans, but disparities remain

Article published March 17, 2014


By Sabriya Rice
“Dramatic” progress has been made in reducing colon cancer incidence and death rates in the U.S., but concerns remain about “striking” racial and socioeconomic disparities, according to new national statistics on colorectal cancer.

During the past decade, colon cancer incidence rates dropped by 30% in adults 50 and older, with the largest improvements seen in people older than age 65, the group most likely to die from the disease, found the report published Monday in CA: A Cancer Journal for Clinicians.

“We were very surprised to see that kind of drop in just one decade. That’s enormous,” said Rebecca Siegel, director of surveillance information for the American Cancer Society, and a co-author of the report.

Typically, declines in cancer rates average 1% to 2% annually, Siegel said, but in the case of colon cancer it was closer to 4%, which the report attributes to widespread increases in colonoscopy screening over the years.Between 2000 and 2010, the use of colorectal cancer screenings increased from 19% to 55% among adults ages 50 to 75, the analysis found. In 2010, 64% of people age 65 years and older reported having undergone a recent screening test. “Colorectal cancer is one of the few cancers that we can actually prevent with screening, so it’s a great opportunity,” Siegel said.

Despite the progress, researchers say there’s still more work to do.
“This is a really important and is a lifesaving test,” said Siegel, “but we still have more than a third of adults for whom screening is recommended (who are) not getting tested, and others who say they have never been screened.”

Screening rates remain low among the poor and uninsured, the report said, and there were substantial racial and ethnic differences in both incidence and death rates. For example, the death rate for blacks was 50% higher than that of whites, attributed to disproportionately higher poverty rates in the black community.

With more people gaining access to coverage as a result of the Patient Protection and Affordable Care Act, Siegel says she hopes some of the disparities will be addressed. But in general, she says, she is often shocked by how unaware the public remains on the role they can play in prevention.

“Colon cancer is one of the cancers we do know a lot about in terms of risk factors,” she said noting that any effort to encourage patients to achieve and maintain a healthy weight, increase physical activity, eat plant-based diets low in red and processed meats and quit smoking can help.

Colon cancer is currently the third leading cause of death for both men and women in the U.S. This year more than 136,000 individuals are projected to receive a colorectal cancer diagnosis, and more than 50,000 are projected to die from the disease.

The CA report used colon cancer incidence data drawn from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program and the North American Association of Central Cancer Registries, and mortality data from the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The CDC last November issued a report noting that comparative effectiveness data have shown at-home stool tests to be equivalent to colonoscopies at catching cancer early in patients who don’t have additional risk factors.

Follow Sabriya Rice on Twitter: @MHSRice

Understanding Obamacare: 5 Facts About the ‘Affordable Care Act’


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We’ve heard about it in bits and pieces over the past three years —the Affordable Care Act  (ACA) also known as “Obamacare.” The political spectacle around this legislation is one thing, but what’s more important is understanding the specific details and making sense of what it really means to you. Fortunately, AARP is here to untangle the jargon and empower readers with the answers and information that nightly news bites don’t offer. Whether you are a senior citizen or a millennial, the Affordable Care Act can have serious impact on your health care, so take notes!

Beginning Jan. 1, 2014, the ACA will provide 6.8 million uninsured African-Americans an opportunity to get affordable health insurance coverage. The bottom line is if you are not insured, low cost or free plans will soon be available. If you already have insurance, you may be able to find an even more affordable plan.

Here are 5 facts about the ACA or “Obamacare”:

  • 3.1 million young adults have gained coverage through their parents’ health insurance plans. This includes more than 500,000 young African-American adults between ages 19 and 25, according to the U. S. Department of Health and Human Services (HHS).
  • 6.3 million seniors are paying less for prescription drugs. And if you have Medicare Part D, and you reach the coverage gap or “doughnut hole” in 2013, you will get more than a 50 percent discount on brand name prescription drugs and more than a 20 percent discount on generic drugs while in the coverage gap. The discounts will continue until 2020 when the gap will end.
  • 105 million Americans are paying less for preventative care and no longer face limits on lifetime coverage, according to HHS. The 4.5 million elderly and disabled African-Americans who receive health coverage from Medicare also have access to many preventive services with no cost-sharing, including annual wellness visits with personalized prevention plans, diabetes and colorectal cancer screening, bone mass measurement and mammograms, according to HHS.
  • 17 million children with pre-existing conditions are no longer denied coverage or charged extra. The issue of pre-existing conditions has been a consistent barrier to obtaining insurance. Under the ACA, beginning in 2014, insurance companies can no longer deny you coverage, even if you have a pre-existing condition like asthma, diabetes, high-blood pressure or even cancer. And if you or a family member gets sick or injured, insurance companies can’t cut off your coverage or cancel your plan.
  • ACA will provide greater access to affordable quality health care, and will also “invest in prevention and wellness, and give individuals and families more control over their care,” according to HHS. Because African-Americans suffer from diseases such as obesity, heart disease, and diabetes at higher levels than America’s general population, this is a critical component of the plan.

So how do you get started with the benefits? Starting October 1, 2013, you can log on to, and search the newly formed “Health Insurance Marketplace.” The website will present competing insurance agencies and help guide health care seekers—individuals, families and small businesses —to the best decisions on which plan to choose or switch over to.

For more information about the Affordable Care Act and how the law applies to you, visit AARP’s Our goal is to make it plain.

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Minorities & The ACA: What The Affordable Care Act Means For Minorities

July 18, 2013 11:16 AM |


The Affordable Care Act (ACA) will affect the health care of every American in some form as it continues to be implemented. The law’s intended effects are particularly targeted on certain groups. For example, the ACA creates a new Office of Minority Health to address disease prevention, health promotion, risk reduction, healthier lifestyle choices, use of health care services and barriers to health care. Some of the largest minority groups in America include African Americans, Hispanics, American Indians, Alaska Natives, Asian Americans, Native Hawaiians and Pacific Islanders.


The problem of health disparities

Before the ACA was passed, minorities tended to suffer from what is commonly called “health disparities,” which is simply one way of saying that minorities tended to suffer more from health issues than the majority population. For example, the 2010 Census Bureau report found that minorities tend to have lower infant mortality rates, and also have lower life expectancy than Whites.

More specifically, look at the following 2010 statistics from the Office of Minority Health for the 43.8 million African Americans (14 percent of the overall population) living in the United States:

  • 44 percent of African Americans in comparison to 62 percent of non-Hispanic Whites used employer-sponsored health insurance.
  • 28 percent of African Americans in comparison to 11 percent of non-Hispanic Whites relied on Medicaid, public health insurance.
  • 20.8 percent of African Americans in comparison to 11.7 percent of non-Hispanic Whites were uninsured.
  • In 2009, the death rate for African Americans was higher than Whites for heart diseases, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS and homicide.

The statistics are also glaring for the 52 million Hispanics (approximately 16.7 percent of the population) who live in the United States:

  • Hispanics have the lowest insured rates of any racial or ethnic group; just 39.6 percent of Mexicans are insured, 51.6 percent of Puerto Ricans, 51.6 percent of Cubans and 46.4 percent of other Hispanic and Latino groups.
  •  In 2010, 30.7 percent of the Hispanic population was not covered by health insurance, as compared to 11.7 percent of the non-Hispanic White population.
  •  Hispanics have higher rates of obesity than non-Hispanic Whites.
  • The rate of low birth weight infants is lower for the total Hispanic population in comparison to non-Hispanic Whites.
  •  Puerto Ricans have a low birth weight rate that is 60 percent higher than the rate for non-Hispanic Whites.
  • Also Puerto Ricans also suffer disproportionately from asthma, HIV/AIDS and infant mortality.
  • Mexican-Americans suffer disproportionately from diabetes.

According to the Office of Minority Health, these health disparities are caused by a number of factors, with economics being one of the leading factors. For example, 26.6 percent of Hispanics, in comparison to 14.9 percent of non-Hispanic Whites, work within service occupations, and those occupations tend to not provide health benefits. The unemployment rate for African Americans was twice as high as the unemployment rate for Non-Hispanic Whites, according to the 2010 Census Bureau report.

The ACA attempts to address these health disparities in a number of ways.



Before the problem can appropriately be solved it must first be fully understood. To that end, Congress funded the National Institute on Minority Health and Health Disparities with $831 million for scientific research on how to improve minority health and eliminate health disparities.


Expansion of Medicaid

Since many minority groups tend to suffer from higher levels of poverty, they also tend to rely more on programs such as Medicaid. Medicaid covers nearly 40 percent of African-American and Latino children. The ACA expands coverage in 2014 up to 133 percent above the poverty level. Nearly half of the current group of uninsured people would qualify for Medicaid under this new criteria.


Community health centers

The ACA provides $11 billion in funding to double the number of patients that are provided primary and preventative services by community health centers. In 2009, 34 percent of health center patients were Hispanic or Latino and 28 percent were African American.


Employer mandate

In addition, the ACA will attempt to expand employer-provided health insurance coverage to many minorities who work in lower-paying jobs. Under the law, employers with more than 50 employees will have to pay a fine if any of their employees receive a premium credit for purchasing their own insurance because they were not offered insurance from their employer.



Minorities have historically suffered from worst health outcomes in the United States due to a number of factors. The ACA attempts to expand health insurance coverage for minorities and improve overall health through research, public programs and mandated private insurance.




Ryan Witt is a freelance writer covering all things St. Louis Cardinals. His work can be found on


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