Active patient involvement is key to increasing the incidence of colon cancer screening
Get Your Rear In Gear 5K promotes colon cancer awareness
A recent study published in the Archives of Internal Medicine compared different methods of reaching patients who are are overdue for colon cancer screening. The study, “Patient and Physician Reminders to Promote Colorectal Cancer Screening” evaluated outcomes for patients who received mailed reminders versus patients who were reminded by physicians during primary care office visits. According to researchers, “mailed reminders to patients are an effective tool to promote colorectal cancer screening, and electronic reminders to physicians may increase screening among adults who have more frequent primary care visits.” Results of the study highlight the importance of active patient involvement in improving colon cancer screening rates, especially among those who are overdue for screening.
Patients who participated in the study ranged from 50-80 years of age and were overdue for colorectal cancer screening. Some subjects were randomly selected to receive a mailing which included educational information about colon cancer screening along with a fecal occult blood test. Others visited a physician who had received an electronic reminder to consult with the patient regarding colon cancer screening. Those who received the mailing were significantly more likely to complete the fecal occult blood test and move on to colonoscopy if the test results warranted action. “The clear advantage of patient involvement over physician reminders in our study suggests that future strategies should increasingly involve patient-based activity. Promising alternatives include the use of the Internet to facilitate patient-provider communication and promote increased patient involvement in their preventive health issues.”
Patient involvement goes hand in hand with awareness and education. Chicago based Rush Health Associates recently offered an online screening tool to the general public after a successful introduction to their patient population. Feedback provided by primary care physicians within the RHA system indicated that since screening guidelines vary based on individual characteristics such as family history and symptoms, many patients were unclear about whether or not a colon cancer screening procedure was necessary. The Colon Cancer Screening Tool was developed in cooperation with gastroenterology physicians so that patients could take the test and get a more specific action plan.
In Seattle, gastroenterologist Dr. John Brandabur points to the significant influence of peers in helping to encourage patients to get in for screening. “Coworkers and friends are the most influential group, second only to spouses,” says Brandabur. At Virginia Mason Medical Center, where Dr. Brandabur practices, letters are generated to patients who are in need of screening. “If there is no response,” says Brandabur “a certified letter goes out.” Primary care physicians at Virginia Mason also use computer based preventative care reminders. Like the prompts used in the study, these are electronic reminders for physicians to ask key questions about family and medical history and to encourage screening. Brandabur notes that in addition to primary care physicians, gynecologists are in a natural position to encourage patients to get screened.
Outside of the medical arena, social incentives also help patients get proactive about screening. Events such as the Colon Cancer Coalition’s Get Your Rear in Gear 5K give communities a platform to have fun with the terms and techniques associated with colon cancer screening. This helps participants become more comfortable asking questions during physician visits. Promotion and coverage of screening procedures on television is also becoming more prevalent, as is discussion about colorectal health by prominent figures. Brandabaur points to the impact that Ronald Reagan’s 1985 colonoscopy and subsequent surgery had on a generation who simply did not discuss medical issues, much less issues involving the colon. Now, even twenty somethings are seeing colon cancer based episodes of popular television shows such as Keeping up with the Kardashians and finding familiar characters like Homer Simpson getting screened on internet sites such as SU2C After Hours.
Promoting good health outside of the physician’s office may be the key to making an impact on colon cancer screening rates. As the study indicates, active participation gets results. Opportunities for patients to be involved in their own preventative care, whether they are online, in their workspace, at a social event or in front of a television screen can increase screening rates and ultimately impact the rates of survival for this devastating disease.
