Providing screening alternatives increases test rates for colorectal cancer.

Providing screening According to new research led by the University of Pennsylvania’s Perelman School of Medicine, the rate of colorectal cancer screenings more than doubled when patients were offered a choice between a take-home kit and a colonoscopy, as opposed to just receiving the colonoscopy. The study, which was conducted through a community health center with approximately 50% of patients covered by Medicaid, was published in Clinical Gastroenterology and Hepatology. It offers valuable insights on increasing screening rates among populations that are often less inclined to undergo the test.

Patients at average risk—that is, those without a personal or family history of the disease, among other considerations—are now advised to undergo colon cancer screening, starting at age 45. There are two primary approaches: either a person must do a colonoscopy every ten years in order to be deemed “up-to-date,” or they can finish a colonoscopy once a year in place of one at home if no abnormal findings are found.

Providing screening alternatives increases test rates for colorectal cancer.

Providing screening Mehta’s study revealed that less than 6% of individuals who were solely offered a colonoscopy finished the procedure in six months. However, completion rates increased to nearly 13 percent when patients were offered the option to select between a colonoscopy and a fecal immunochemical test (FIT), which may be finished at home and returned in, pre-paid, to the lab. About 10% of the group that was given the option to choose between the two procedures had colonoscopies.

In one research arm, participants were simply given the FIT kits, and only 11% of them finished the course of treatment in less than six months. Although this was an improvement above the colonoscopy-only offer as well, FIT kits are normally used to ensure that a patient has a one-year history of colorectal cancer screening. Colonoscopies enable the removal of precancerous polyps and can detect cancer in its early stages. A patient could receive screening updates for up to ten years with just one screening.

Providing screening In a community health center located in Pottstown, Pennsylvania, 738 people between the ages of 50 and 74 participated in the study. The group was referred to the researchers as “socio-economically underserved,” with almost half of the patients being on Medicaid and a baseline screening rate of roughly 22% before to the trial—much lower than the roughly 72% national average.

Even though this study produced encouraging results, additional work needs to be done. “There are certainly colonoscopy access issues across the country due to recovery from a slowdown during the pandemic and the expansion of screening recommendations for the younger population, but it might affect community health center populations more,” Mehta stated. “Colonoscopy is important for screening, diagnosis of symptoms, and follow-up of positive stool testing, but we should think about offering less invasive options as an alternative and as a choice if we want to increase screening rates.”

Providing screening alternatives increases test rates for colorectal cancer.

Providing screening This study’s provision of screening by postal outreach, which has been demonstrated to increase screening rates in the past because it doesn’t require patients to visit the clinic, was another significant feature. The low response rate overall might also have been accounted by this.

With the surge in colorectal cancer cases among individuals under 50, research on screening protocols may be more important in improving monitoring and results among even younger populations than those under study.

Providing screening The National Comprehensive Cancer Network’s Young Investigator Award provided funding for this study. Additionally, the National Cancer Institute (K08CA234326) provided some funding for it.

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