March is colorectal cancer (CRC) awareness month. While the morbidity and mortality associated with colorectal cancer is well understood by the medical community, many patients aren't aware that the recommended screening age for CRC has changed from 50 to 45.1
They're also often not aware of less invasive screening options for colorectal cancer, which is the nation's second leading cause of cancer death.2
During a February webinar hosted by Becker's Hospital Review and sponsored by Exact Sciences, a global advanced cancer diagnostics company, panelists discussed colorectal cancer awareness and new techniques they're using to drive awareness and increase screening rates. Panelists were:
- Durado Brooks, MD, Deputy Chief Medical Officer, Screening, Exact Sciences
- Allison Church, LPN, Manager, Quality Transformation, Edgewood, Ky.-based St. Elizabeth Physicians
- Deena Stewart, RN, BSN, digestive health nurse navigator, Ashland, Ky.-based King's Daughters Medical Center
Five takeaways:
1. Early detection of colorectal cancer is critical. CRC has a roughly 90 percent five-year survival rate when diagnosed in stages I or II compared with a roughly 10 percent survival rate if diagnosed at stage IV.3,4 Also, first-year treatment costs for patients diagnosed at stages I or II is approximately $58,000 versus almost $109,000 for patients diagnosed at stage IV, according to research cited by the panelists.5
2. CRC screening is an underused preventive health strategy. According to the American Cancer Society, as of 2018 about 67 percent of adults aged 50 to 75 report being up to date with CRC screening, but only about 21 percent of adults who are 45 to 49 are up to date.6 Dr. Brooks commented, "It's been said that colorectal cancer is the most preventable yet least prevented form of cancer. Despite all the efforts that have gone into boosting screening rates, we're still missing a lot of opportunities."
3. To increase awareness of CRC screening options, start with the team. Ensuring providers are aware of screening alternatives is step one. Ms. Stewart said that when she started her position, "There didn't seem to be much conversation about alternatives to colonoscopy. We needed options for our patients." Ms. Church agreed, noting that her organization implemented a shared decision-making process so patients and providers could jointly decide the best screening tool to use. "That was the big first step, educating the providers," she said.
4. Harness the EHR to advance screening goals. EHRs can be equipped with features that help providers identify patients in need of CRC screening and help track the process. This has been shown to improve screening rates by almost 25 percent, according to research cited during the webinar.7 These features include:
- EHR interfaces so screening tests can be quickly and easily ordered, and test data is populated in the EHR.
- Electronic patient communication tools for scheduling and education.
- "Best practice" alerts and "missed opportunity" features.
- A workbench that allows targeting groups of people based on certain characteristics and bulk-ordering tests for that group.
- Structured and user-friendly data-tracking, such as screening status, results and health history to ensure information is up to date.
"That investment in health information technology and utilizing this technology effectively is one way that health systems can boost screening rates pretty impressively," Dr. Brooks said.
5. Buttress efforts with patient outreach and awareness campaigns. Media appearances and marketing splashes can help raise awareness; both Ms. Church and Ms. Stewart said their organizations work to get the word out. Using a health risk assessment has been a great tool for targeting younger people. "A lot of people aren't comfortable discussing this with a provider," Ms. Stewart said. "If they can do it anonymously and do it online they can discover if they qualify for a colon cancer screening; that's been a wonderful tool to have."
To achieve sufficient rates of screening among eligible patients, more must be done to improve awareness about the importance of colorectal cancer screening and of the various screening options available. Though EHR optimization, value-based incentives and outreach, providers are finding innovative ways to better inform patients.
Ms Stewart is a paid speaker presenting on behalf of Exact Sciences. Ms Church is a contracted speaker presenting on behalf of Exact Sciences.
To register for upcoming webinars, click here.
References:
1. Davidson KW, Barry MJ, Mangione CM, et al. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(19):1965-1977. doi: 10.1001/jama.2021.6238
2. American Cancer Society. Colorectal cancer statistics: How common is colorectal cancer? 2022. Accessed March 16, 2022. https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html
3. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer Statistics, 2021. CA Cancer J Clin. 2021;71(1):7-33. doi:10.3322/caac.21654.
4. ACS. Survival Rates for Colorectal Cancer, by Stage. Accessed June 9, 2021. https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html.
5. California Healthcare Foundation. Cancer Care Spending in California: What Medicare Data Say, 2015. Accessed May 18, 2021. www.chcf.org/wp-content/uploads/2017/12/PDF-CancerCareSpendingMedicare.pdf.
6. American Cancer Society. Colorectal cancer facts & figures 2020-2022. 2020. Accessed April 15, 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf.
7. Green BB, Wang CY, Anderson ML, et al. An automated intervention with stepped increases in support to increase uptake of colorectal cancer screening: a randomized trial. Ann Intern Med. 2013;158(5, pt 1):301-311.
M-US-CG-03066 March 2022