March is Colon Cancer Awareness Month and colon cancer screenings are an important step toward early diagnosis, but many people avoid colonoscopies because of fear of discomfort. Colonoscopies are recommended every 10 y>ears for both men and women over the age of 45 but according to 2010 figures from the Centers for Disease Control and Prevention (CDC), less than 65 percent of adults 50 years and older received his or her colorectal cancer screening as appropriate.
The Sarah Cannon Patient Navigation Program has launched a new community-focused program to improve participation, especially among minority populations who are less likely to receive routine screenings. Sarah Cannon, HCA's global cancer enterprise, has more than 200 oncology-trained nurse navigators guiding patients through every facet of cancer care.
"We've been distributing Fecal Immunochemical Test or FIT kits in the Nashville market, and this month we are hosting "lunch and learns" at each TriStar hospital in Middle Tennessee to distribute free FIT tests to employees and community members. We then plan to expand these efforts to other Sarah Cannon centers across the United States," explained Johanna Bendell, MD, Director, Gastrointestinal (GI) Cancer Research Program. "FIT screens for occult or hidden blood in the stool that could be a sign of precancerous polyps or colon cancer. A trained nurse navigator specialized in GI cancer will follow up with participants regarding their results and serve as a guide to schedule additional testing and coordinate insurance needs."
Raising the Compliance Rates
While the FIT shouldn't replace colonoscopies, Dr. Bendell said the test is a new way of improving the community's health awareness and ultimately getting those in need of healthcare scheduled for necessary appointments.
"Ideally, we would like everyone over the age of 45 to receive a colonoscopy and those with a family history of colon cancer to begin screenings even earlier. One out of three people in that age group has not been screened for colon cancer," she said. "With the FIT kits, there's an 80 percent compliance rate, which increases early diagnosis. Patients can find out if they are at increased risk for colon cancer and should undergo additional testing. It's our way of making health screenings more convenient and less complicated - a key approach to improving outcomes for patients."
Making Screenings More Patient-Friendly
FIT kits are just one of a number of patient-friendly screening options that have recently become available for colon cancers. Other screening options include CT colonography ("virtual colonoscopy"), fecal occult blood tests (FOBT) and Given Imaging's PillCam¨ technology for colon cancer. Most recently, the first non-invasive DNA screening test for colorectal cancer. This test is also fecal-based, coupling sensitivity toward patient preference for less invasive options with the demand for more reliable screening methodologies.
While some of these new screenings may be less effective than more invasive procedures and may lead to false positives, Dr. Bendell pointed out that these alternative methods are better than no screening at all, especially for patients who would otherwise forgo screening.
"It's always better to get some information as opposed to none at all. We want to take whatever steps we can do to catch cancer when it's in an operative, curable stage," she said. "This is especially true for colon cancer, which tends to mutate as it progresses, making it resistant to various treatments. If we can detect the polyps before they become abnormal, we can help to prevent the cancer altogether."