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How to prevent disparities in colon cancer screening
Date:6/16/2014

SEATTLEPeople living in poverty are less likely to be screened regularly for colorectal cancerand more likely to develop the disease and die from it. How to end these disparitiesand raise screening rates, lower disease rates, and prevent deaths? A promising way is to mail fecal immunochemical tests (a newer kind of stool test) to populations, Beverly B. Green, MD, MPH, and Gloria D. Coronado, PhD, wrote in the June 17 JAMA Internal Medicine.

Dr. Green is a Group Health physician and an associate investigator at Group Health Research Institute. Dr. Coronado is a senior investigator and the Mitch Greenlick endowed scientist for health disparities at Kaiser Permanente Center for Health Research, in Portland. The journal invited them to write a commentary about a study that David W. Baker, MD, MPH, of Northwestern University led and published in the same issue of the journal.

Drs. Green and Coronado applauded Baker's study for achieving repeat screening rates of more than 82 percent in a largely low-income community. But they were disappointed that only 60 percent of individuals with a positive screening stool test completed follow-up diagnostic colonoscopy. "Lack of a follow-up colonoscopy defeats the purpose of a stool-test screening program," said Dr. Green, who is also an assistant clinical professor at the University of Washington School of Medicine.

Previous studies have shown that when low-income people get colorectal cancer screening, they tend to prefer the option of doing a stool test in the privacy of their own home. But when the test is "positive" (detecting microscopic blood in the stool), people need to get a second test: a follow-up diagnostic colonoscopy. After a positive stool test, nearly a third of people have advanced pre-cancers that can be removed during the follow-up colonoscopyand 4 percent have colorectal cancer.

"For many people, the barriers to receiving the needed follow-up diagnostic co
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Contact: Rebecca Hughes
hughes.r@ghc.org
206-287-2055
Group Health Research Institute
Source:Eurekalert  

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