Providing colonoscopy and home tests doubled colorectal cancer screening

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In a significant study led by the Perelman School of Medicine at the University of Pennsylvania, researchers found that offering patients a choice in their colorectal cancer screening method dramatically increased screening rates.

This research, conducted at a community health center in Pottstown, PA, involved 738 patients aged 50 to 74, many of whom were socio-economically underserved and about half were Medicaid recipients.

Published in Clinical Gastroenterology and Hepatology, the study revealed that when patients were given the option to choose between a colonoscopy and a take-home fecal immunochemical test (FIT), screening rates nearly doubled compared to offering just a colonoscopy.

Specifically, when the choice was provided, the rate of screening completion within six months jumped to almost 13%, compared to just under 6% when only a colonoscopy was offered.

Furthermore, about 10% of the group opted for a colonoscopy when given a choice, while approximately 11% completed the FIT kits when only this method was offered.

Colon cancer screenings are crucial as they help detect early stages of cancer and can lead to the removal of pre-cancerous polyps, potentially saving lives.

Colonoscopies are recommended every ten years for individuals at average risk, which includes those without a personal or family history of colorectal cancer, among other factors. In contrast, FIT kits need to be completed annually unless abnormal results are found.

The study’s lead author, Shivan Mehta, MD, MBA, MSHP, who is an associate chief innovation officer and an associate professor of Gastroenterology at Penn Medicine, emphasized the importance of offering choices in maximizing screening rates without overwhelming patients.

He noted that such approaches not only cater to patient preferences but also enhance participation by accommodating different comfort levels and lifestyles.

The backdrop of this study is crucial, considering the baseline screening rate at the health center was about 22%, significantly lower than the national average of 72%.

The use of mailed outreach for offering screenings, which has been previously shown to increase participation, was a key component of the study’s methodology. This strategy is particularly effective as it does not rely on patients needing to visit the clinic.

Despite these promising results, Mehta acknowledged ongoing challenges, including access issues to colonoscopies exacerbated by the pandemic and expanded screening recommendations for younger demographics.

The study underscores the need for continued research and adaptation of screening strategies, particularly as colorectal cancer rates have been rising among individuals under 50.

Overall, this study highlights the potential of tailored healthcare approaches that respect patient preferences and promote accessibility, thereby improving public health outcomes in colorectal cancer prevention and early detection.

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The research findings can be found in Clinical Gastroenterology and Hepatology.

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