"I was unfamiliar with the term, so I asked my doctor to describe it,” Florez recalls. “When he did, I said, ‘Oh no, I’m not doing that.’” A year later, when Florez returned for some routine tests, his doctor insisted, and though Florez displayed no symptoms, the tests came back positive for cancer.
“I wished I’d done [the screening] the year before,” says Florez, a retired postmaster living in Holbrook, Arizona. “It was a ‘macho’ thing.”
Juan Nogueras, M.D., chief of staff at Cleveland Clinic Florida, finds this reluctance among Hispanics common — and disturbing.
“Hispanics are not as diligent as non-Hispanics about undergoing screening and, since there are no symptoms for early-stage colon cancer, we tend to present at an advanced stage, when the prognosis is worse,” says Nogueras, a board-certified colorectal surgeon.
Colorectal (colon and rectal) cancer statistics for Hispanics are alarming. It’s the second most commonly diagnosed cancer, and the second cancer-leading cause of death in men, third among women. Each year about 5,500 Hispanic men and 4,900 women are diagnosed with the disease, and about 1,600 men and 1,500 women die from it, according to the American Cancer Society.
Colon cancer occurs when polyps, or growths, in the colon become cancerous. During a colonoscopy, a doctor can detect and remove polyps, preventing cancer from occurring.
But people are often reluctant to undergo a colonoscopy because they fear it will be painful (it isn’t; it’s done under sedation); and they don’t want to do the preparation, which involves a thorough colon cleansing.
When it comes to Hispanics, there’s even more resistance. Among those 50 and older, the screening rate for Hispanics is 31.9 percent, compared to 49.5 percent for non-Hispanic whites, according to the National Center for Health Statistics. Rates vary among subgroups (see chart below).
One reason for the discrepancy is a strong resistance to rectal exams, says Jose Mendoza-Silveiras, M.D., medical consultant and Medical Scientific Advisory Committee member at the Colon Cancer Alliance: “Women, like men, do not want a doctor to touch them there. They feel it is improper.”
Experts also attribute the low screening rates to a general reluctance by Hispanics — especially women — to examine their bodies, an extreme fear of cancer and a lack of resources to deal with serious medical issues should they arise.