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by: Charlotte Libov | from: AARP VIVA
When Juan Florez turned 60, his doctor recommended a colonoscopy.
“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.
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.
Education, experts say, is the best prevention. Key messages include raising awareness of the symptoms, letting Hispanics know that colon cancer is highly treatable and informing them that colonoscopies are done under sedation with no discomfort.
At least two organizations around the country have made colon cancer outreach a key part of their work. One effort is the Hispanic Access Foundation’s national five-year Juntos Podemos Contra el Cáncer campaign. The foundation has pilot programs in Denver, Colorado, and Yakima, Washington, and in 2012 it plans to launch a multifaceted program that includes a major media campaign, community workshops and affiliations with Spanish-language churches and local health professionals.
And then there’s Juan Florez, who has his own one-person word-of-mouth initiative. After his diagnosis, he had surgery and chemotherapy — which he believes he could have avoided if he’d had the colonoscopy when his doctor first recommended it. Now 65 and healthy, Florez considers himself lucky.
“A friend wouldn’t go to the doctor for anything, and he was diagnosed with late-stage colon cancer, which killed him,” says Florez, who now constantly tells his friends: “Go and get the test, and then you won’t have to have it done again for another five or 10 years. You’ll have gotten it out of the way.”
Read about six ways to prevent colon cancer risk from AARP VIVA.
Eighty-three percent of Hispanic respondents to a Health Information National Trends Survey (HINTS) reported never seeking cancer information from any source. Those who sought cancer information experienced dissatisfaction with their search.
Hispanics reported low confidence overall in their ability to obtain cancer information.
Close to 30% of Spanish-speaking individuals had little to no confidence in their ability to obtain cancer information compared to 6% of non-Hispanics and 11.5% of English-speaking Hispanics.
Among Spanish-speaking Hispanics, 67% said their last search for cancer information took alot of effort, 55% said the information was hard to understand, and 58% had concerns about the quality of the information they found. Among English-speaking Hispanics, the information-seeking experience was slightly better; with 43% saying their last search took a lot of effort, 25% saying the information was hard to understand, and 60% having concerns about the quality of information they found.
The bottom line is, more information needs to be made available in Spanish about cancer. HAF is attempting to address this need through our “El Cancer Nos Afecta a Todos” campaign.
The Migration Policy institute just released a report: Department of Homeland Security and Immigration: Taking Stock and Correcting Course. The report makes 36 recommendations for improvements that the Obama administration can make immediately, without any change in legislation, in order to improve effectiveness and implementation of current, often criticized, immigration laws and agencies. In doing so the federal goverment would build American confidence, a crucial first step to creating new mandates.
There is widespread agreement that the nation’s immigration laws and system are badly broken. However, the legislative measures that would be required to fix them would be sweeping and controversial. So the timetable for enacting reforms is uncertain.
A complete list of the recommendations can be found at: www.migrationpolicy.org. Some of the recommendations are included below:
- US Customs and Border Protection should halt construction of border technology pending a review of the effectiveness of such measures.
- ICE , in accordance with its mission, should focus its operations on the criminal enterprises that underlie large-scale illegal migration. Its investigations should be prioritized to target worksites that terrorists may attempt to infiltrate and employers who intentionally hire unauthorized workers in order to depress wages, undermine working conditions, and gain an unfair competitive advantage.
- ICE should routinely refer for criminal prosecution those who commit egregious or repeated violations of immigration law, or who commit unrelated criminal offenses. ICE should not overuse criminal charges in routine immigration-status violation circumstances.
- Supervised release programs run by ICE should be expanded for discretionary detainees who do not threaten national security or public safety, and who would not represent a flight risk while under supervision.
- The Social Security Administration’s (SSA) “no-match” program, whose purpose is to credit earnings to those who paid into the system, should not be used by DHS as an immigration enforcement tool.
- Funding for USCIS should be “right-sized” and adjudication procedures should be streamlined so that the agency can break the recurring cycle of backlogs that impedes its ability to function as a true immigration services agency.
- To encourage legal immigration for all who are eligible for benefits under current laws, USCIS should adjudicate in the United States, not at consulates abroad, “extreme hardship” waivers for persons approved for family-based visas.