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Rate Of Cancer Decline Uneven

ALBUQUERQUE, N.M. — Rates of colorectal cancer have declined nationally for decades for men and women of all ethnic groups, including Hispanics.

But for New Mexico Hispanics, the incidence of the deadly cancer has generally crept up or remained unchanged since 1990, even as rates declined significantly among the state’s Anglos.

A recent study by University of New Mexico researchers suggests that lower rates of colorectal screening among New Mexico Hispanics helps explain why they have made less progress than Anglos against the disease, which will kill an estimated 350 New Mexicans this year.

Colorectal cancer screening
The New Mexico Department of Health offers free colorectal cancer screening for New Mexicans age 50 and older who lack insurance and meet certain income guidelines.
The screenings are offered through clinics around the state, including First Choice Community Healthcare, La Familia Medical Center, Ben Archer Health Center and First Nations Community Healthsource.
For more information, call Dana Millen at 222-8601 or see www.cancernm.org and link to colorectal under “types of cancer.”

Both in New Mexico and nationally, Hispanics are less likely than Anglos to stay up-to-date with screening tests that can detect and even prevent colorectal cancer.

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Anglos “are more likely to be up-to-date on their screening, so it would make sense that that’s why they had a decline in cancer rates,” said Melissa Gonzales, a UNM professor of epidemiology and lead author of the study.

But Gonzales said she had no explanation why New Mexico Hispanics have failed to make progress against the disease while rates declined among Hispanics nationally.

“It’s something unusual that’s happening here,” said Gonzales, who plans additional research into that question. “Obviously, screening is not the whole answer.”

A variety of other risk factors for colorectal cancer rates, including tobacco and alcohol use, diet and exercise, and chronic conditions such as obesity and diabetes, may work against New Mexico Hispanics, she said.

Colorectal cancer, a cancer of the large intestine and rectum, is the second-leading cause of cancer deaths in the United States, killing about 53,000 U.S. men and women a year, according to the Centers for Disease Control and Prevention.

About 143,000 Americans are diagnosed annually, making colorectal cancer the third most commonly diagnosed cancer.

The American Cancer Society estimates that 840 new cases of colorectal cancer will be diagnosed this year in New Mexico.

Symptoms can include chronic stomach aches and cramps and blood in the stool. But patients often experience no symptoms until the cancer is advanced.

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The best way to lower your risk of colorectal cancer is by having regular screening tests beginning at age 50, according to the CDC. Sixty percent of colorectal cancer deaths could be prevented if Americans complied with recommended screening, the agency estimates.

“Though (colorectal cancer) screening rates have increased in the U.S., Hispanic men and women are less likely to comply with screening guidelines than whites at both the state and national levels,” according to the UNM study.

Recent surveys of New Mexicans ages 50-75 found that 50 percent of Hispanics were up-to-date on colorectal cancer screening, compared with 63 percent of Anglos, the state Department of Health found.

“Two factors, lack of insurance and not having a usual source of care, consistently explain Hispanic-white disparities” in colorectal cancer screening, the study said.

Most people receive one of two kinds of screening tests, which differ widely in cost. They are:

♦ Colonoscopy, which uses a flexible, lighted tube to check for polyps, or abnormal growths in the colon or rectum that can become cancerous. A colonoscopy is recommended every 10 years.

♦ Fecal occult blood testing, or FOBT, which tests for the presence of blood in fecal matter. The test can detect subtle bleeding in the gastrointestinal tract – a red flag for the presence of cancer or polyps. The test is recommended each year.

Gonzales said colonoscopies have become the “gold standard” of colorectal cancer screenings because a doctor can remove most polyps and some cancers during the procedure.

“It’s not just a screening measure – it’s a preventive measure,” she said.

But lack of insurance is a formidable barrier to colonoscopy, because of the procedure’s high cost, Gonzales said. The website NewChoiceHealth.com surveyed seven Albuquerque clinics and found that the cost of a colonoscopy screening ranges from $2,175 to $7,000.

The Kaiser Family Foundation estimates that 29 percent of New Mexicans aged 19 to 65 lack any kind of health insurance.

The high cost of colonoscopy is a key reason a state program recommends a low-cost fecal occult blood test as the first line of defense against colorectal cancer, said Dana Millen, program manager of the New Mexico Department of Health’s colorectal cancer program.

The CDC-funded program pays for the test, which costs $25 or less, for uninsured and underinsured New Mexicans, Millen said. If the test reveals a potential problem, the program will pay for a colonoscopy, she said.

New Mexico has a shortage of specialists who can perform a colonoscopy, Millen said. Colonoscopy also has some risks because it can puncture the colon, she said.

“The safer route, and the less expensive way to go for those of average risk, is to do the FOBT test,” Millen said.


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