CRC Prevention Gaps Persist in Younger Black, Hispanic Populations Facing Most Advanced Cases: Jordan Karlitz, MD

In this clip, Jordan Karlitz, MD, of Exact Sciences, continues his conversation with The American Journal of Managed Care^® about colorectal cancer (CRC) becoming the leading cause of cancer-related deaths among individuals aged younger than 50. He focuses on disparities across racial, ethnic, and socioeconomic groups, what this shift reveals about gaps in early detection and prevention, and how those gaps can be addressed.

Karlitz began by highlighting his prior research, which analyzed changes in the proportion of advanced-stage CRC cases in the Surveillance, Epidemiology, and End Results database over the past decade. Published in Cancer Epidemiology, Biomarkers & Prevention, the study found an increase in advanced-stage CRC cases among younger adults, highlighting gaps in early detection. Notably, the largest increases occurred among non-Hispanic Black and Hispanic populations, particularly individuals in their 20s and 30s.

Karlitz underscored that these findings demonstrate persistent disparities in awareness and access to timely care. To improve overall early-stage CRC diagnosis rates, he emphasized the importance of the 3 pillars of prevention and early detection.

The first is timely screening, beginning at age 45 for individuals at average risk, according to the current guidelines. The second is understanding one’s family history of cancer, which may warrant earlier screening. The third is taking concerning symptoms, such as rectal bleeding and changes in bowel habits, more seriously and acting on them early, rather than dismissing them as other causes.

“I think a gap in any of these 3 pillars could increase your risk for CRC development and, unfortunately, lead to presenting with more advanced-stage disease,” Karlitz said. “I think to address some of these potential gaps in these 3 pillars that I just mentioned are education and public health messaging.”

Watch part 1 to learn more about the factors contributing to rising CRC-related deaths among younger adults and what this population should know about their risk.

Reference

Montminy EM, Zhou M, Maniscalco L, et al. Shifts in the proportion of distant stage early-onset colorectal adenocarcinoma in the United States. Cancer Epidemiol Biomarkers Prev. 2022;31(2):334-341. doi:https://doi.org/10.1158/1055-9965.epi-21-0611