• Posted May 21, 2024

To Boost Colon Cancer Screening, Give Patients Choices

Giving patients a choice between screening methods could help doctors detect colon cancer earlier, a new study shows.

More than double the number of patients underwent colon cancer screening if they were given a choice of the type of test they'd prefer, researchers report.

Only 6% of patients completed screening within six months if they were only offered a colonoscopy, results show. Meanwhile, only about 11% completed screening if they were only offered a take-home fecal test kit. 

But if they were offered the choice between a colonoscopy or a take-home test kit, the screening rate jumped to nearly 13%.

Further, when given a choice, the proportion of people who got a colonoscopy increased to 10%, they added.

“Offering the choice of colonoscopy or take-home kits seem to have the advantage of maximizing the rates of colonoscopy -- the most effective screening tool -- while not overloading individuals with too much of a choice, which could have lowered overall participation,” said lead researcher Dr. Shivan Mehta, Penn Medicine's associate chief innovation officer and an associate professor of gastroenterology.

Colon cancer screening is now recommended for people at average risk starting at age 45, researchers said. Those with personal or family history of colon cancer might need to start sooner.

Colonoscopies are recommended once every 10 years. While invasive, these procedures allow doctors to remove precancerous polyps that could develop into colon cancer over time.

But people can also choose to take a fecal immunochemical test once a year. They collect a sample at home and mail it into a lab, where it's analyzed for hidden blood in stool that can be an early sign of colon cancer.

For the study, researchers offered colon cancer screenings to 738 patients ages 50 to 74 at a community health center in Pottstown, Pa. About half of the center's patients were on Medicaid, and researchers described the people it treats as “underserved.”

This center had a screening rate of about 22% for colon cancer, much lower than the national average of 72%, researchers noted.

The study was published recently in the journal Clinical Gastroenterology and Hepatology.

While offering patients a simple choice boosted rates, the researchers think more even more options could bring greater numbers in for screening.

“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 said in a UPenn news release.

“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,” Mehta added.

More information

The National Institutes of Health has more on fecal immunochemical tests.

SOURCE: University of Pennsylvania, news release, May 16, 2024