Colorectal Cancer in African American Men, Research Paper Example

Introduction

Cancer is a serious disease that impacts males and females throughout the life span. Specifically, colorectal cancer is a particularly challenging diagnosis for many men, especially African American males who experience significantly higher mortality rates than other groups (Brittain, Loveland-Cherry, Northouse, Caldwell, and Taylor, 2012). Screening for colorectal cancer is difficult because significant disparities exist in the use of these tools for African American males and males and females of other cultures (Brittain et.al, 2012). Therefore, family nurse practitioners must play a critical role in improving screening for colorectal cancer among African American males reduce disparities that exist in screening for this population (Brittain et.al, 2012). The following discussion will address colorectal cancer and its impact on African American males, emphasizing the importance of family nurse practitioners in supporting improvements in the screening, diagnosis, and treatment.

Discussion

Colorectal cancer has the second highest mortality rate of all cancers in the United States, as precancerous polyps often go undetected in patients who are not properly screened (CDC, 2014). Risk factors include persons over the age of 50, those persons with a history of colorectal cancer, those with inflammatory bowel disease, and a number of possible lifestyle factors (CDC, 2014). Furthermore, African American males are at the highest risk, followed by Whites, Hispanics, and Asians (CDC, 2014). Approximately 140,000 persons annually are diagnosed with colorectal cancer, and another 50,000 die from the disease (CDC, 2014). It is important to recognize the symptoms that could lead to a possible diagnosis, such as stomach pain, blood in the stool, and unexplained weight loss (CDC, 2014). The United States government has recommended comprehensive screening efforts for colorectal cancer, for which family nurse practitioners should be involved in order to improve the frequency of screening, particularly for African American males (DHHS, 2014).

Colorectal cancer represents a significant cost burden to patients and to the healthcare system as a whole. All forms of cancer contribute to over $263 billion in healthcare costs and lost productivity (CDC, 2011). This disease continues to be prevalent throughout society, and as a result, requires additional attention towards screening to promote early detection and to reduce the prevalence of the disease in adults (CDC, 2011). The Colorectal Cancer Control Program has been effective in increasing screening rates for adults over the age of 50, particularly in lower income populations to improve evidence-based practice and screening tools (CDC, 2011). In spite of these advances, colorectal cancer screening continues to be difficult to expand in some communities, particularly those where there is limited knowledge and understanding of the risks and frequency of the disease (CDC, 2011).

One of the key issues that requires further examination is the lack of understanding of colorectal cancer screening as it relates to African Americans (Bass et.al, 2011). Some African American males, for example, are not aware of colorectal screenings or may not participate because they primary type of screening tool, the colonoscopy, appears to have a sexual meaning (Bass et.al, 2011). Furthermore, they possess a significant lack of trust in their physicians and would rather not be sedated for any medical procedure (Bass et.al, 2011). Therefore, it is widely perceived by healthcare professionals that the African American community and particularly males, do not possess sufficient knowledge of this screening tool and its potential life-saving impacts (Bass et.al, 2011). Therefore, there is a significant gap in education and knowledge regarding colorectal cancer in many communities; as a result, advanced practice nurses must be active contributors in the development of new strategies to improve outcomes for patients who are at risk of colorectal cancer (Bass et.al, 2011). This is an essential component in the development of new perspectives to improve screening rates throughout the United States (Bass et.al, 2011).

The use of screening tools for colorectal cancer are on the rise; however, they remain difficult to obtain in areas where low incomes are evident and insurance coverage is lacking (Blumenthal et.al, 2010). Therefore, education is critical to the increased utilization of these screenings for at-risk populations, including African American males (Blumenthal et.al, 2010). In addition, a stigma appears to be attached to the colonoscopy, in addition to a general fear of a cancer diagnosis, poor knowledge, and fewer recommendations by healthcare providers (Blumenthal et.al, 2010). These factors must be addressed on a comprehensive basis in order to accomplish the desired objectives in screening, diagnosis, and treatment in patients (Blumenthal et.al, 2010). It is also necessary to evaluate the type of educational programs that are available so that patients are provided with the best possible framework to make decisions regarding screening (Blumenthal et.al, 2010). Furthermore, some screening techniques or programs are more effective than others and must be considered when performing outreach to the desired population group (Blumenthal et.al, 2010). These strategies will encourage the development of new perspectives to expand knowledge and interest in screening for colorectal cancer and promote early detection (Blumenthal et.al, 2010).

Family nurse practitioners working in community settings must address the problems associated with low screening rates for colorectal cancer, particularly for African American males. Most importantly, cultural barriers must be broken down, knowledge must be shared, and apprehension regarding cancer and diagnosis should be lifted as best as possible. This requires a comprehensive and detailed commitment to excellence that will enhance outcomes for patients and support a greater level of compliance with screening objectives as sought by advanced practice nurses.

The gap in screening within African American male population requires significant attention and focus so that there is a greater understanding of the history of these gaps, why they continue to exist, and how advanced practice nurses might be successful in reducing some of these gaps in the future. Therefore, one area to consider is the development of an educational program regarding colorectal cancer screening that addresses the impact of this disease on African American males. It is more important than ever for screening tools to be widespread and available to all income levels, regardless of insurance to promote knowledge and awareness of the disease.

Conclusion

Colorectal cancer screening has become increasingly prevalent in many communities and continues to be problematic. It is important for family nurse practitioners to educate the general public regarding these screenings, particularly for males and females over the age of 50. Furthermore, since African American males are of higher risk, this group must obtain non-discriminatory education, guidance, and knowledge from healthcare providers as a means of improving screening rates and to reduce fear and apprehension regarding this tool. The lives of those at high risk for colorectal cancer may be saved if they are screened and early detection is achieved in cases where a cancer diagnosis is evident. This will encourage the development of new perspectives to educate the public regarding this important and highly valuable screening tool for the population groups most at risk of developing the disease.

References

Bass, S. B. , Gordon, T. F., & Ruggieri, D. G. (2011). Perceptions of colorectal cancer screening in urban African American clinic patients: Differences by gender and screening status. Journal of Cancer Education, 26(1), 121-128.

Blumenthal, D. S., Smith, S. A., Majett, C. D., & Alema-Mensah E. (2010). A trial of 3  interventions to promote colorectal cancer screening in African Americans. Cancer, 116(4), 922-929.

Brittain, K., Loveland-Cherry, C., Northouse, L., Caldwell, C. H., & Taylor, J. Y. (2012). Sociocultural differences and colorectal cancer screening among African American men and women. Oncology Nursing Forum, 39(1), 100-107.

CDC (2011). Cancer: Addressing the cancer burden. Retrieved March 6, 2013 fromhttp://www.cdc.gov/chronicdisease/resources/publications/aag/pdf/2011/Cancer_AAG_2011_Web_508.pdf

CDC (2014). March is National Colorectal Cancer Awareness Month. Retrieved March 6, 2013 from http://www.cdc.gov/cancer/dcpc/resources/features/ColorectalAwareness/

DHHS (2014). Cancer. Retrieved March 6, 2013 from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=5