CDCR Chief Medical Officer says colon cancer screenings have importance
Incarceration is bad for your health.
Colon cancer is the second leading cause of cancer death in California prisons, and incarcerated persons tend to have a higher mortality rate than the population on the outside.
“I feel it is important to check for colon cancer because I was told it is higher in males. I would rather be safe, and the fact that they can detect and treat it before it is too late,” San Quentin resident Carlos Sanches said.
March is Colon Cancer Awareness month and when asked, several residents said they were unaware of the danger posed by colon cancer.
The California Department of Corrections and Rehabilitation provides screenings to detect colon cancer and refer for treatments.
“People may decide not to test, but it is the obligation of the care team to explain the importance of preventative measures for colon cancer,” said Dr. A. Pachynski, Chief Medical Executive at SQRC, said. “I want to destigmatize the perceptions around colon cancer screenings.”
“I believe there are many reasons why a colonoscopy should be done, and it’s not just for cancer,” resident C. Rooms said. “Colon cancer took my father, so that it is possibly heredity is a scary thing to think about.”
Rooms felt that CDCR should offer testing at younger ages if there are risk factors. He also believed there were not enough preventative measures in the system and often services are not available until symptoms begin to show.
Colon cancer is a growth of cells in the large intestine that begin as clumps called polyps. These polyps often do not cause symptoms and generally are not cancerous, but can turn into colon cancer over time, which is why doctors recommend regular screening tests.
According to a Cancer Medicine article, several studies have reported higher cancer prevalence among incarcerated people compared to the general population. “Health care is constitutionally guaranteed during incarceration, stated the article. Incarcerated individuals (in Canada and other settings) often do not receive recommended cancer screening or experience significant delays in screening during incarceration.”
Resident A. Kramer said he has faced barriers with healthcare services during his incarceration, often feeling as though his needs were ignored. “We should have the option to pay if we wish to get routine procedures.”
Dr. Pachynski said residents can pay for their own treatments but the costs include custody protection to and from the hospital or clinic.
“There is a 90% colon cancaer survival rate if treated in early stage. It is easier here to provide proper health care than on the outside,” Dr. Pachynski said. “But there is a perception of lack of access or people do not know how to ask for what they want or need, so I believe communication and trust are part of the issue.”
Several other risk factors include old age, family history with colon cancer, inflammatory bowel diseases, low-fiber, high-fat diet, not exercising regularly and obesity.
Dr. Pachynski said that more than 48% of the population is 50+. “Our screening percentage is higher than some prisons. Eighty-three percent of our residents eligible for colon cancer screening have been screened in the last year.” She said if there is no evidence of cancer in the initial colon screening, then another is not needed for 5-10 years, but if a fit test is administered it requires an annual check. Pachynski said if there are abnormal findings in the tests then a reference to a local off-site oncology group is made for treatment.
“I had a colonoscopy at CMC and they were on it, but each prison and doctor is different,” Kramer said. “The fasting and requirements leading up to the procedure was worse than the procedure itself.”
Despite difficulties, incarcerated individuals can help themselves by making several healthy lifestyle changes to help reduce the risk of colon cancer. Officials have several recommendations:
1. Eating the fruits, vegetables, and grains in state-supplied meals will provide vitamins, minerals, fiber, and antioxidants, which may help prevent cancer.
2. Exercising most days of the week for at least 30 minutes and maintaining a healthy weight are highly recommended.
3. Also, abstaining from smoking and alcohol are preventative measures to lowering the risk of cancer.
“I would not disagree that educating persons on medical services is an area we can focus on better. I want to understand how to reach people more,” Dr. Pachynski said.
