Racial Disparities Persist in Colorectal Cancer Outcomes
Entrenched racial disparities across the care continuum for colorectal cancer (CRC) reveal a complex interplay of modifiable and nonmodifiable factors that contribute to disproportionate disease burden among Black individuals, authors of a recent review stated.
Black Americans experience higher CRC incidence, greater mortality, and lower survival rates compared with their White counterparts, the authors observed in the review published in Nature Reviews Gastroenterology & Hepatology. These disparities can be “largely attributed to social determinants of health (SDOH), such as access to health care, socioeconomic conditions and systemic inequities.” The investigators acknowledge that some biological risk factors exist but note that data supporting biology as a driver of disparity are limited.
A critical portion of the review focuses on disparities in CRC screening participation and access to guideline-concordant treatment. Evidence indicates that these gaps are both measurable and, importantly, remediable. According to the authors, “Black–White differences in CRC screening participation, CRC incidence and CRC mortality can be resolved,” suggesting that targeted interventions can yield tangible improvements.
Successful programs have demonstrated that disparities can be mitigated through community engagement, patient navigation services, and structural health system reforms. However, long-term equity demands broader systemic change, including sustained investment in the social infrastructure that underlies health inequities. The authors advocate for a dual approach: expanding immediate access to screening and treatment while addressing historical and structural SDOH.
This review underscores the urgency of confronting inequities across all phases of CRC care and calls for a unified effort within the healthcare system to eliminate disparities and improve outcomes for all populations.
Reference:
May FP, Mehtsun WT, Jemal A, Gupta S. Black–White disparities across the colorectal cancer care continuum in the USA. Nat Rev Gastroenterol Hepatol. Published online July 21, 2025. doi:10.1038/s41575-025-00856-9
