Why Black Americans face higher colorectal cancer rates and what researchers say can help

Colorectal cancer has a disproportionate impact on Black communities in the United States, where the incidence rate is about 20% higher and the mortality rate is about 30% higher compared with white individuals. A new study co-led by a UCLA researcher and published in Nature Reviews Gastroenterology & Hepatology examines why these disparities persist and, crucially, what can be done to address them.

The research emphasizes that there is limited data supporting biological factors as the primary cause of these disparities. Instead, the evidence points to social determinants of health — such as access to care, socioeconomic conditions, and systemic inequities — as the main drivers. These factors create significant barriers, leading to lower screening rates and less access to timely, guideline-compliant treatment for Black Americans.

For too many people, the chance to avoid a colorectal cancer diagnosis or for cure if diagnosed just doesn’t exist, not because of biological differences, but because of how social and environmental factors influence access to high-quality screening and care. — Dr. Folasade May of UCLA, the paper's lead author.

However, the researchers stress that these disparities are solvable. The review highlights several proven interventions that have successfully closed the gap, including culturally tailored education programs and systems that help individuals get screened. Dr. May noted that in systems that provide equal access to all, like the Veterans Health Administration, racial disparities in screening do not exist.

The paper recommends a dual approach to eliminate these inequities. The first step is a short-term focus on ensuring all individuals have health insurance and the opportunity to receive high-quality screening and treatment. The second is a long-term commitment to addressing the underlying social and economic conditions that fuel these health disparities in the first place.