By Gracie Ann E. Dinkins, MD, FACS and Sydney Y. K. Brown, MA, Special to California Black Media Partners

Every breakthrough in cancer care carries a promise: earlier detection, better treatment and longer life. California has helped deliver that promise through world-class cancer centers, a statewide cancer registry and major public-health investments. Yet colorectal cancer still exposes a painful divide: Black Californians are more likely to develop the disease and far more likely to die from it than their White neighbors.

The numbers are stark. From 2014 through 2018, the age-adjusted colorectal cancer incidence rate was 40.2 cases per 100,000 Black Californians, compared with 35.8 among non-Hispanic White Californians. The mortality rate was 25.3 deaths per 100,000 among Black Californians and 17.7 among White Californians—a 43% difference. 

A later state analysis showed that the incidence gap remained in 2021, at 39.0 versus 35.0 cases per 100,000.

These differences should not be treated as an inevitable consequence of biology. The more revealing explanation lies in what happens—or fails to happen—across the cancer-care continuum: prevention, screening, diagnostic follow-up, treatment and surveillance after treatment.

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Colorectal cancer is one of the few cancers that screening can sometimes prevent. Colonoscopy can find and remove precancerous polyps, while stool-based tests can identify people who need further evaluation. The U.S. Preventive Services Task Force recommends screening for average-risk adults from ages 45 through 75, with several acceptable options. But a screening test saves no one if it is never offered, never completed or not followed by a timely colonoscopy after an abnormal result.

California’s cancer-burden report shows both the urgency of the problem and a troubling data gap. Nearly six in 10 colorectal cancers were diagnosed at a regional or distant stage among both Black and White patients from 2009 through 2018. The racial difference in stage was not statistically significant. Yet, the registry report did not include screening information, so it could not show who was offered a test, who completed it or who received the necessary colonoscopy afterward. It also did not assess whether survivors completed recommended follow-up. California can count cancers and deaths, but it cannot yet see every missed opportunity that produced them.

The disparities become clearer after diagnosis. A California Cancer Registry study of nearly 27,000 people with stage I through III colorectal cancer found that Black patients had 39% higher odds of receiving less than guideline-recommended treatment and 78% higher odds of waiting more than 60 days for treatment than White patients. Neighborhood socioeconomic disadvantage explained part of the substandard treatment, but racial differences persisted even after researchers accounted for where patients lived.

Survival reflects the accumulation of these missed opportunities. Among Californians diagnosed from 2009 through 2013, five-year relative survival was 58.8% for Black patients and 65.1% for White patients. After researchers adjusted for age, insurance, neighborhood income, stage, chronic illness and other factors, the survival difference was no longer statistically significant. That does not make the gap less serious. It identifies much of it as potentially preventable: when access, timing and health conditions are unequal, survival will be unequal too.

California already has proof that a better system can work. Kaiser Permanente Northern California built an organized program that identified eligible patients, mailed annual home stool tests to those overdue, offered colonoscopy as an alternative, and tracked abnormal results through follow-up. Screening among Black members rose from about 40% in 2009 to 80% in 2019. Over the same period, their colorectal cancer death rate fell from 54.2 to 20.9 per 100,000, essentially eliminating the Black-White mortality gap within that health system.

The lesson is not that every Californian must join one health plan. It is that equity requires organized care rather than reliance on chance encounters. Mailed screening outreach, patient navigation and guaranteed follow-up colonoscopy should become standard across Medi-Cal, county health systems and community clinics. Health systems should publicly report screening completion; time from a positive stool test to colonoscopy; time from diagnosis to treatment; receipt of guideline-concordant therapy; and completion of post-treatment surveillance—each stratified by race, insurance, and neighborhood.

Transportation, paid time off, bowel-preparation costs, childcare and distrust are not side issues; they determine whether patients can complete care. Community organizations, churches, clinicians and public hospitals should help design outreach from the beginning, not merely deliver messages created elsewhere. Survivors should leave treatment with a clear surveillance plan, navigation support and reminders that do not disappear when active therapy ends.

Closing California’s colorectal cancer gap is achievable. The state has the tests, specialists, data systems and proof of concept. What it needs is the will to connect them. Success should be measured not only by how many cancers we treat, but by how many we prevent, how quickly we act and whether every Californian has an equal opportunity to survive.

About the Authors 

Gracie Ann E. Dinkins, MD, FACS, is a Clinical Assistant Professor of Surgery and Surgery Clerkship Director at the Charles R. Drew University College of Medicine, Department of Surgery. Her mission is to help realize the CDU vision: Excellent health and wellness for all in a world without health disparities.

Sydney Y. K. Brown, MA, is a medical student at the Charles R. Drew University College of Medicine whose work focuses on clinical research, community engagement, and health equity. She is committed to advancing equitable access to high-quality care and improving health outcomes in underserved communities.

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By Emil Amok Guillermo

Americans complain about inflation.

Filipinos complain about surviving.

That’s not a knock on America. It’s a reminder that for millions of Filipino Americans, the Philippines isn’t some faraway place we visit on vacation. It’s where our parents were born. Where our cousins still live. Where grandparents are buried. Where every phone call home can begin with, “We’re okay,” or, just as easily, “We need help.”

The Bay Area is home to one of the nation’s largest Filipino communities. California alone has nearly two million Filipinos—roughly half of all Filipino Americans in the United States.

Every year, Filipino Americans send an estimated $17 billion from the United States to the Philippines. Those remittances account for roughly a tenth of the Philippine economy. One wire transfer may keep children in school, put food on the table, pay hospital bills, or help elderly parents make it another month.

That’s why Filipino Americans were paying attention to President Ferdinand Marcos Jr.’s State of the Nation Address this week.

They were listening for justice.

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They were listening for Lyle Prijoles.

Prijoles, a 40-year-old Filipino American from Hayward, was killed on April 19 during a Philippine military operation in Negros Occidental. Also killed was Kai Sorem, a 26-year-old activist from Seattle.

The Armed Forces of the Philippines say those killed were connected to the Communist Party’s New People’s Army.

Their families say otherwise.

Human-rights advocates describe Prijoles and Sorem as labor organizers and peaceful activists working alongside sugar workers struggling under crushing poverty. Prijoles had traveled repeatedly to the Philippines since 2006, documenting conditions in Negros and advocating for farm workers whose lives rarely improve no matter who occupies the presidential palace in Manila.

Those conflicting stories are exactly why members of Congress, led by Rep. Pramila Jayapal (D-WA-7), have called for an independent investigation.

After all, two American citizens are dead.

If an ally’s military kills Americans under disputed circumstances, shouldn’t we want to know exactly what happened?

Yet the story barely made news in the United States.

Perhaps because it’s inconvenient.

It’s inconvenient for Manila – and Washington.

Strategic allies aren’t supposed to kill American citizens.

The Philippines isn’t just another country.

It’s family.

President Marcos had bigger issues on his mind this week.

China’s growing aggression in the West Philippine Sea dominated much of the speech. Marcos rightly rejected racist insults aimed at Filipinos and insisted his country would not surrender its sovereignty.

“We are not racists. We are not liars,” Marcos declared. “We are respectful, and we are dignified. We are Filipinos, and we do not yield.”

Strong words.

But patriotism isn’t measured only by how forcefully a government stands up to China.

It’s also measured by how a government treats its own people.

The Philippines inherited many of America’s democratic institutions. Even the “State of the Nation Address” echoes our “State of the Union.” Congress. Elections. Constitutional government. We exported the architecture of democracy.

What we couldn’t export was accountability.

That’s why activists like Lyle Prijoles believed ordinary workers deserved better.

And that’s why his death matters.

About the Author

Emil Guillermo is an award-winning journalist, political analyst and comic monologist. See him on his microtalk show on YouTube at @emilamok1.

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By Antonio Ray Harvey, California Black Media

Photo Caption: 

Assemblymember Tina McKinnor (D-Inglewood) is advancing legislation that would prohibit unauthorized drones from operating within 400 feet of large outdoor ticketed entertainment events. 

Assembly Bill 2113, titled “Aviation: Unmanned Aircraft Systems: Ticketed Entertainment Events,” passed the Senate Public Safety Committee on June 30 by a 6-0 vote and was referred to the Senate Appropriations Committee. 

The Assembly approved the bill May 18 on a bipartisan 72-0 vote, with support from 54 Democrats and 18 Republicans. AB 2113 must clear the Senate Appropriations Committee before the Legislature’s Aug. 31 deadline to remain active. 

“Large, ticketed entertainment events such as concerts, festivals, and sporting events bring thousands of people into dense confined spaces, including many venues in my (California State Assembly District 61),” McKinnor said. “Unauthorized drones and activities in these settings pose a real risk to public safety and can interfere with event operations and emergency response.” 

McKinnor said the legislation would establish a state-level restriction that local authorities could enforce while preserving the federal government’s authority over U.S. airspace. 

McKinnor also said, “While the Federal Government regulates airspace, local law enforcement is responsible for protecting public safety on the ground, yet current law does not provide a clear state-level prohibition addressing this issue.

Under the bill, the restriction would apply to outdoor professional music, sporting, or performing arts events held at venues with a capacity of at least 1,000 people.

Each violation would be an infraction punishable by a $500 fine. 

McKinnor, who chairs the Assembly Select Committee on the 2028 Olympic and Paralympic Games and the Los Angeles County Legislative Delegation, said the restrictions are particularly important as California prepares to host major international gatherings, including the 2028 Olympic and Paralympic Games. 

“AB 2113 protects the intellectual property rights of artists and addresses a growing public safety gap at public events due to the growing use of drones across California,” said McKinnor, a member of the California Legislative Black Caucus (CLBC). 

The Association for Uncrewed Vehicle Systems International (AUVSI) has raised concerns about the bill’s potential effects on legitimate commercial drone operations. 

Mason Sisk, the group’s director of government affairs, said AB 2113 would address the “disruptive use of drones,” including operations that infringe on artists’ intellectual property. However, the trade association has asked McKinnor’s office to add an exemption for commercial flights providing services such as cargo transportation and infrastructure inspections. 

“Our issue with the bill really has to do with the distinction between the ‘loitering and hovering’ and the disruptive use of drones. So, I would ask that the committee not support the bill until we have language figured out,” Sisk told the Senate Committee on Public Safety.

To address concerns raised during the legislative process, McKinnor accepted amendments that narrowed the bill’s scope and exempted certain authorized operations. The prohibition would not apply to venue-approved flights, venue employees conducting official business, regulated utility employees performing official duties, or emergency personnel responding to an incident. 

“My office and the sponsor have been engaging with stakeholders throughout this process, and I want to thank everyone for their patience and collaboration,” McKinnor said. “We remain committed to working in good faith as the bill moves forward to address concerns of stakeholders.” 

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