By Lori Solomon, Editor, Diagnostic Testing & Emerging Technologies
The U.S. Centers for Disease Control and Prevention announced $22.8 million in awards to increase colorectal cancer screening, particularly among at-risk and uninsured populations. The 31 awardees will work with health system partners and use evidence-based intervention strategies to increase the number of people screened.
The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening for men and women aged 50 to 75 years using high-sensitivity fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy. According to the American Cancer Society, colorectal cancer is the third most commonly diagnosed cancer and is the third leading cause of cancer death in both men and women in the United States. The frustrating part, experts say, is that the majority of colorectal cancers and associated deaths could be prevented by applying existing knowledge about cancer prevention and increasing the use of recommended screening tests.
Screening rates for colorectal cancer have remained notoriously low with only 59 percent of recommended people receiving guideline-consistent testing in 2010, the latest year for which data is available. This failure to screen results in the low number of colorectal cancer patients (40 percent) receiving a diagnosis when the disease remains highly treatable in localized-stage.
Research has focused on identifying and overcoming barriers to screening. Commonly cited reasons for failure to screen include: inadequate provider communication, education, and/or reminders; patient testing preferences; and general lack of access to health care.
Since the CDC launched the Colorectal Cancer Control Program (CRCCP) in 2009, it provided almost 55,000 colorectal cancer screening exams and diagnosed 165 colorectal cancers and 8,441 cases of precancerous polyps. In the 2014 program year, CRCCP screened 13,425 people. To further increase the number of people screened, the CDC is requiring all grantees to work with health systems partners to use a combination of evidence-based strategies for effective community preventive services. These evidence-based strategies include:
- Patient reminders—Evidence supports that sending letters, postcards, e-mails, or phone messages to patients increases screening rates.
- Provider reminders—Adding reminders for screening recalls to patient medical records, including with the use of electronic alerts, aids clinician communication to patients.
- Provider assessment—Tracking and giving providers feedback as to how many of their patients receive screening services, compared to other local providers or state and national averages has been shown to improve their performance and boost screening rates.
- Education tools—Small media (videos and printed materials) can help provide needed education and motivate people to get screened, particularly when used in conjunction with one-on-one education or client reminders.