Colorectal Cancer

Alarming Trends in Colorectal Cancer

The recent death of actor Chadwick Boseman from colon cancer at age 43 is drawing attention to the alarming increase in cases among adults under the recommended screening age, as well as racial disparities for case rate and mortality.

Boseman was diagnosed when he was only 39 year old in 2016. This young age is far below the current recommendations from organizations to begin screening that hover at ages 45 or 50. Moreover, his death highlights the fact that Blacks incur the highest incidence and mortality rates of colorectal cancer of any ethnic group in the United States, being more often diagnosed with CRC at an earlier age and with more advanced disease.

  • Oncologists: Chadwick Boseman’s death from colon cancer at 43 underscores a disturbing trend
    By Sorbarikor Piawah, Gabriel A. Brooks and Franklin W. Huang | SF Chronicle | Sep. 3, 2020

    ...There exist persistent racial disparities — Black colon cancer patients are 40% more likely than white patients to die from their cancers. While Mr. Boseman’s cancer would not have been detected under current screening guidelines, it is clear that detecting colon cancer earlier and identifying individuals at higher risk should be an important priority... > read more

  • UCSF doctor hopes death of actor Chadwick Boseman will raise awareness as more young people diagnosed with colon cancer
    Featuring Dr. Alan Venook | | August 30, 2020

    ..."Younger people with symptoms, let's say bowl symptoms, diarrhea, or blood in their stool, will know that they may be at greater risk of colon cancer than they thought and will be seen by their physicians. Perhaps more important, the physicians, primary care doctors, need to be thinking of colon cancer earlier than they usually would. You tend to dismiss a 30 or 35 year old as not likely to have cancer. Well, we unfortunately see that that's changed."  >read more

SF Stories read more

Joseph Chen
After my 50th birthday, my physician reminded me it was time for my first colonoscopy. I thought I’d always lived a pretty healthy lifestyle. I didn't think it was an urgent matter needed to be done right away. I finally got around to getting it two years later and was stunned when my doctor told me I had early-stage colon cancer. I never expected it could happen to me.
>read more

These FIT and Colonoscopy Educational Videos can help explain the importance of screening:

CRC Video

San Francisco Cancer Initiative’s Colorectal Cancer Task Force with the help of animator Mark Wooding of University of California, San Francisco created an educational video on colon cancer screening in English, Cantonese, and Spanish. These videos highlight the importance of colon cancer screening for individuals between the ages of 50 to 75. The two detection methods illustrated in the videos are the fecal immunochemical test (FIT) and Colonoscopy. 

We can reduce the rates of colorectal cancer by improving early detection and screening.

Colorectal cancer is the second leading cause of cancer death in the United States and a leading cause of years of life lost to cancer in San Francisco.

Screening detects precancerous polyps before cancer can develop, as well as early stage cancers at a time when they can be cured. It is one of the most effective ways to prevent colorectal cancer deaths.

As colorectal cancer screening rates have increased locally and nationally, incidence and mortality from colorectal cancer has started to decline.

UCSF is committed to supporting the 80 by 18 campaign in San Francisco. 80 by 18 means raising the screening rate to 80% of eligible adults by 2018. Many of San Francisco’s health systems are already close to this level of screening, but there is still much to do , particularly among the underinsured and those who belong to medically vulnerable groups served by safety net clinics.

First steps

In our first year, SF-CAN will support safety net clinics belonging to the San Francisco Community Clinic Consortium. This includes technical assistance to increase screening rates, thorough reporting systems, and improving patient navigation to ensure that people with abnormal screening tests receive timely follow up.

UCSF, the American Cancer Society, San Francisco Health Plan, Zuckerberg San Francisco General Hospital, and other community stakeholders are partnering in these efforts.



  • American Cancer Society
  • San Francisco Community Clinic Consortium
  • San Francisco Department of Public Health
  • San Francisco Health Plan
  • UCSF
  • Zuckerberg San Francisco General Hospital and Trauma Center


Task Force Recommendations:

By increasing completion of fecal immunochemical tests (FIT) among average risk patients, increasing the screening rate in participating clinics to 80%, and pursuing follow up colonoscopies with at-risk patients, the Task Force hopes to decrease the rate of colorectal cancers in San Francisco within 5 years.



Goal: Increased standardization around stool-based testing using single sample FIT

Method: Collaboration with community partners and the San Francisco DPH to all safety net clinics in SF use single sample FIT.



Goal: Increase screening of at-risk populations by 10% each year

Method: Help clinics increase CRC screening rates by providing materials, training, and technical assistance. Patient registries established



Goal: Decrease proportion of people without a follow-up colonoscopy within one year of an abnormal FIT by 10% each year

Method: Systematically identify patients with positive FIT and other high-risks and refer to ZSFG for colonoscopies