For almost eight months, Jenna Scott had the ideal pregnancy. Then the bleeding, dizziness and abdominal pain started.

Scott, 29, feared something was wrong with her baby, but her OB-GYN told her everything was fine after her appointment. Her baby could be sitting on her organs or perhaps she was experiencing typical pregnancy-induced hemorrhoids. The abdominal issues were explained as routine pregnancy aches and pain.

Having never been pregnant, Scott didn’t know what was normal. But even after giving birth to her son, Cameron, the rectal bleeding continued, and Scott was exhausted. She was told the intense fatigue was normal for a new mother and she still could be suffering from hemorrhoids.

When nothing changed a year after giving birth, Scott realized she needed to see a primary care physician. There, she received a referral to a GI specialist who ordered a colonoscopy to rule out more significant issues. Instead, the test confirmed something no one expected — at 31, Scott had colon cancer. She’d later learn it was stage 4.

Read: My Doctor Dismissed My Colon Cancer Red Flags as Normal Pregnancy Symptoms >>

Scott knows her younger age, healthy lifestyle and lack of family history of colon cancer made it less likely for a provider to offer screening, even though her rectal bleeding and abdominal pains were typical colon cancer symptoms. She’s not entirely sure if racial bias played a role, although she was a Black woman with a team of all white male doctors. Scott said the providers at her OB-GYN practice were very apologetic when she told them about her diagnosis.

Still, Black people are less likely to report receiving a colon cancer screening recommendation from their physician and they’re less likely to get screened, raising questions as to whether provider bias contributes to worse outcomes for many people of color. Native American and Alaska natives have the highest rates of colorectal cancer, followed by Black men and women. Black patients had the highest mortality rates for the disease.

Renee Williams, MD, MHPE, a gastroenterologist with NYU Langone Health, has examined possible reasons why Black patients were less likely to get a recommendation for colon cancer screening and referrals to surgical and cancer services. She said bias may come into play if a provider thinks a patient doesn’t want screening or can’t afford it, especially if they’re uninsured, but she sees social determinants of health and other external factors playing a bigger role in screening disparities.

Screening is extremely important because polyps can be removed before they turn into cancer, and survival rates are high if colorectal cancer is treated early. Routine screening has caused the colon cancer mortality rate to drop for multiple decades.

“Provider bias definitely exists, and it exists in all physicians regardless of their background, but I think it’s more than that,” Williams said. “Often, the providers just don’t have a lot of time. If you have 20 minutes to see your patients and they have diabetes, high blood pressure or heart disease, a lot of your time is spent dealing with that. Discussing routine screening may become less important.”