Colorectal Cancer Screening

How to Improve Colorectal Cancer Screenings

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States and affects all racial and ethnic groups. African-Americans have the highest incidence of CRC of any group and are less likely to have undergone diagnostic testing and screening.

"Colorectal Cancer in African-Americans", American Journal of Gastroenterology, 2005.

What We Can Do to Help Prevent CRC

Physician’s Role	Priority Health Assistance
Recommend routine preventive CRC screening of men and women at age 50 (age 45 for those that are at high risk). Facts: African-Americans are more responsive to recommendations from their personal physician. If the physician fails to mention CRC screening, patients may conclude it is not necessary. 10.6% of African-Americans present with colorectal cancer before the age of 50. African-Americans have a higher prevalence of cancerous lesions in the proximal part of the large intestine.	Preventive Health Care Guidelines. If billed with a preventive diagnosis, we'll cover the cost of CRC preventive screenings and offer options: Fecal Occult Blood (FOB), sigmoidoscopy, barium enema and colonoscopy. Download a copy from the online Provider Center. Print copy available upon request.
Be aware of African-American men’s negative views towards CRC screenings; offer education and support, including personal risk factors. Facts: There is limited knowledge about CRC, and there are negative attitudes toward "manhood-depriving" procedures such as digital/instrumental rectal exams, which bring "shame or embarrassment." Cancer is viewed as a highly stigmatizing illness. Fear of finding cancer is a barrier.	Patient Education. Print "Stop Colon Cancer Before It Stops You" for your patients. Direct your patients to our website for additional information on risk factors, diagnostic tests and cancer treatment options
Use data to identify members who need a screening. Optimize your office strategies to include computer-based reminder systems.	Tracking Systems. Log in to "Patient Profile" at priorityhealth.com to find your patients age 50 and older who are due for a routine preventive CRC screening.
Assess your patients for tobacco use at every visit. Refer to Priority Health’s Tobacco Cessation and PIP programs. The smoking rate of African-Americans has increased and is a common risk factor for CRC.	Prior Authorizations. You can prescribe ANY smoking cessation therapy in our formulary for up to 12 weeks without prior authorization.

Additional Resources

• The Centers for Disease Control (www.cdc.gov) offers sample educational materials, screening strategies, research studies, statistics and more.
• The American Cancer Society at www.cancer.org.
• Screen for Life awareness campaigns offer materials and ideas to raise awareness of CRC screening and remove existing barriers. Go to www.cdc.gov/cancer/Screenforlife.

Physician Education
Visit www.medscape.com for free CME:

• Virtual Colonoscopy May Be Used First in Screening for Colorectal Cancer, valid through Oct. 10, 2008; 0.25 CME
  
• Immunochemistry Superior to Guaiac Test in Detecting Colorectal Cancer, valid through Oct. 9, 2008; 0.25 CME
  
• Obesity a Significant Risk Factor for Colorectal Cancer: Study (0 CME)