A potential strategy to decrease screening disparities and improve outcomes is to give patients more personal options, such as at-home testing.
Offering patients options to test for colorectal cancer may be a good strategy, according to the results of a study by Kaiser Permanente researchers presented at Digestive Disease Week. Investigators in this 20-year population-based study sent at-home kits for fecal immunochemical testing (FIT) along with colonoscopy reminders to patients overdue for colonoscopies.
“If you offer people more than one option for screening—such as colonoscopy or FIT—they’re more likely to get screened than if you offer either option by itself,” Dr. Douglas Corley, researcher and gastroenterologist, said in a news release. “To get above an 80% screening rate, you almost always have to offer people multiple options.”
Understanding FIT
FIT tests in particular are a great way to reach patients who live in rural areas, as well as young adults, who are experiencing more incidents of colorectal cancer even as the overall incidence declines, Corley said in an American Medical Association (AMA) update.
“So there are a lot of positives about it. And that’s one of the reasons why the U.S. Preventive Services Task Force kind of equally recommends colonoscopy and FIT for benefit in terms of decreasing the risk of death from colorectal cancer,” he said in the AMA interview.
FIT tests are a noninvasive way to determine whether someone has blood in their stool. People with positive tests would then follow up with a colonoscopy. Some providers may also order Cologuard testing, which looks for DNA of cells shed in the stool, for abnormalities typical of cancer.
Study Findings
Screening rates—via colonoscopy, sigmoidoscopy, or FIT—grew from 37.4 percent in 2000 to 79.8 percent in 2019 across all racial and ethnic groups, according to the researchers.
Giving patients more options in the type of colorectal cancer screening they receive—including a FIT test mailed to their home—reduced the number of those who got cancer by a third, reduced the deaths in half, and eliminated nearly all the racial differences in screenings, diagnoses, and death.
By Amy Denney
