Tuesday, March 1, 2022
Colorectal cancer is among the top causes of cancer death in Indiana. The number of Hoosiers who die from colorectal cancer is higher than the national average, especially among our Black population. Equally troublesome, Hoosiers lag the rest of the country when it comes to colorectal cancer screening, which has been shown to be effective in decreasing the number of deaths from colon cancer.
We caught up with Victoria Champion, Ph.D., R.N., to learn more about the disease and efforts at the IU Simon Comprehensive Cancer Center to help turn the tide. As associate director of community outreach and population science research, Dr. Champion, an IU Distinguished Professor and Edward W. and Sarah Stam Cullipher Professor at IU School of Nursing, leads the Office of Community Outreach and Engagement.
Q: Most Hoosiers would probably correctly say that lung and breast cancer are among the top causes of cancer deaths in Indiana. Do you think most people would be surprised to know that colon cancer is the third highest cause of death and our Black population are much more likely to get this disease and die from it?
Dr. Champion: Yes, people are often surprised that a colon cancer diagnosis is common and can be deadly. Many people are not comfortable talking about their colon, therefore, it is easy to ignore colon cancer. Secondly, colon cancer does not get the publicity that lung or breast cancer do so people don’t realize how many people it kills or that it is much worse in our Black population.
Q: For many years, you and your colleagues have led research on the cancers that cause the most deaths in Indiana. What has been learned about colon cancer among Hoosiers?
Dr. Champion: We have learned that people don’t like to think about colon cancer because it involves a body function that people consider private or distasteful. Because people don’t like to think about the colon, they also don’t want to think about screening for colon cancer, which can prevent this disease or find it early so that it can be successfully treated. Until people become more comfortable discussing colon cancer and doing something about it, I am afraid it will be a significant cause of death – especially for Hoosiers.
Q: Your office has an impact across the state, not only in trying to reduce both the incidence and mortality rates caused by this cancer but other cancers as well. But, let’s stay focused on colon cancer for the moment. What efforts and partnerships are underway to make Hoosiers aware of this deadly cancer and screening options?
Dr. Champion: The Indiana State Department of Health and the American Cancer Society received a grant from the Centers for Disease Control and Prevention to educate Hoosiers and health care providers about the necessity of colon cancer screening and about the different screening options available. Here at the IU Simon Comprehensive Cancer Center, our researchers are studying ways to implement colon cancer screening options into primary care practices throughout the state. We are currently partnering with the Indiana Rural Health Association to compete for a large implementation grant that will help rural primary-care practices increase their colon cancer screening rates. Finally, we are planning a colon cancer screening program in the Indianapolis area in partnership with the Marion County Health Department to bring colon cancer screening to underserved areas in our state.
Q: Is it true that colorectal cancer is preventable?
Dr. Champion: Yes, colorectal cancer is preventable. Through colonoscopy, precancerous polyps can be removed before they turn into cancer. Additionally, there are several behaviors that increase your risk for colon cancer such as smoking, excessive alcohol consumption, a diet high in red meats, lack of exercise, and excess weight, especially around the middle part of your body. We can do a lot as individuals by maintaining a healthy lifestyle, which can substantially reduce your risk for developing colon cancer.
Q: Do we know why the colon and rectal cancer mortality rate is higher for people who are Black than for white people? Are other minorities also at greater risk of dying from this type of cancer? Are residents of any particular region of Indiana more at risk for developing and dying from colorectal cancer?
Dr. Champion: We know that Black people have lower colon cancer screening rates in Indiana and this could be a significant factor in later-stage diagnosis. We also know that Black people have a higher incidence of obesity, which could put them at greater risk, especially if their excess weight is around the middle part of their body. The mortality for colon cancer is greater in Indiana compared to the average for the nation and, in the Hoosier state, Blackford and Jay counties have higher mortality rates than the state average, but there is not an obvious reason for this occurrence.
Q: What about colon cancer screening, which includes options such as at-home stool tests and colonoscopy? Why don’t Hoosiers take advantage of this life-saving screening?
Dr. Champion: There are many reasons people don’t get screenings – many more than can be discussed here. It is important for people to know that if they are at average risk, there are options. Not everyone has to have a colonoscopy. The United States Preventive Services Task Force guidelines indicate that individuals at average risk for colon cancer have the option of getting a stool blood test or colonoscopy. At-home stool tests offer a good alternative to colonoscopy for many people, but only the individual and his or her doctor can decide what is best.
Q: Through your research, have you found any outreach efforts effective in getting Hoosiers to be screened for various cancers, particularly colorectal cancer?
Dr. Champion: One of the most effective tools is simply having a doctor recommend the test. Another is making colon cancer screening convenient, such as mailing a stool test kit to the patient’s home. Unfortunately, many times people are not screened because a health care provider doesn’t suggest screening at a health care visit or the person forgets to schedule a screening and the physician’s office doesn’t have a reminder system in place.
Q: If you had a magic wand and could change one thing concerning attitudes or behaviors about health in Indiana, what would it be?
Dr. Champion: It would be that people in Indiana must take responsibility for their own health and work with their health care provider to prevent or find cancer early. The majority of deaths from cancer could be prevented if people knew about and worked on healthy behaviors, screening, and prevention. Healthy behaviors that can prevent the development of cancer or detect it early include: not smoking, minimizing alcohol intake, getting cancer screenings as recommended by national guidelines, maintaining a healthy diet, exercising, and maintaining a healthy weight.
Learn more about colorectal cancer