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Cleveland Clinic Florida's Dr. Schneider Says Women In Underserved Communities Could Be Hardest Hit By Post-Pandemic Colon Cancer Diagnoses

Photo: National Cancer Institute
Photo: National Cancer Institute

A study by Epic Health Research Network found colonoscopies dropped by 86 percent from January through April last year. Dr. Alison Schneider is a women’s gastroenterologist at Cleveland Clinic Florida.

WMFE spoke with Schneider about the drop in screenings and how avoiding this painless screening for colon cancer could lead to more deaths in women.

Read the full interview below. 
Danielle: Colon cancer is the third most common cancer in women. And yet you said even before the pandemic, some of your patients who are women weren't coming in for colonoscopies, why do you think that might be?

Dr. Schneider: You know, this was maybe a little bit more of a private issue, you know, maybe they were afraid to, you know, talk to their healthcare providers about, you know, GI issues they might be having.

They were maybe a little issues about privacy, undergoing these procedures. Sometimes they're nervous about what the results might be with these procedures. And I think a lot of it maybe had to do with with the communication that they had had with their providers. I'm a woman gastroenterologist, and I think that most of my patients are women, so maybe they feel more comfortable at times talking to women.

And I think there are more women GIs in the country. And I think hopefully that that helps, and, and more women providers, even in primary care that they feel more comfortable to talk to.

Danielle: And then the pandemic hit, making it even harder for people to seek care. There was a study in The Lancet that predicted a 16.6% increase in colon cancer deaths over the next five years. So what do you tell the women you treat about why not getting a screening could actually be deadly?

Dr. Schneider: Now, the wonderful thing about colon cancer screening is when we screen somebody at the appropriate age, if we find a polyp, polyps are benign lesions, and when we're in there, we have the ability to remove them.

The concern is that we'll find cancers at a later stage where they're not going to be resectable to a one-step surgery or even resectable with advanced endoscopies. There's going to be a lot of morbidity. These are patients that are probably going to have to undergo, you know, what maybe more more palliative types of treatments if it's not resectable or undergo, you know, chemotherapy and additional treatments moving forward.

Danielle: And experts predict women in underserved communities, including Black, Native American and Hispanic women might bear the brunt of these colon cancer deaths. What might explain this?

Dr. Schneider: There was a recent publication by the American Gastroenterology Society that has found that there are hot spots in our country. One of them being near where I live in Miami-Dade County, and basically they're finding that one in 16 contiguous US counties are part of these hot spots, many of them are located in the south of United States, and among women especially so we're talking about women with early onset colorectal cancer.

They're finding there are certain community health behaviors, lack of physical activity, fertility, which seem to be related to early onset colorectal cancers in young patients and not only, you know, an issue of them getting screened, but also these are younger patients that are not getting screened so that the concern is that we may be finding more advanced cancers in these patient populations in the future.

Danielle: Has there been a Chadwick Boseman effect if any on getting more young women and women from minority communities in to get these colon cancer screenings?

Dr. Schneider: It's great that you asked that actually, yes. I did. In my practice, I had actually had a marked increase in the number of people coming in for their colonoscopies and after they had, you know, that, you know, tragic news, they felt like okay, this is time I need to, you know, get my colon cancer screening.

Listen to the full conversation, by clicking on the clip at the top of the page.

Danielle Prieur is WMFE's education reporter.