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Colorectal Cancer Screening: How to Increase Rates


Offering colorectal cancer (CRC) screening to patients when they come to the clinic for wellness visits may be the standard of care, but relying on that strategy alone will miss many patients who do not access healthcare regularly. Although CRC is the second-leading cause of cancer deaths in the United States, rates of screening have not met public health goals.

One reason is the rigors of colonoscopy, which is invasive and requires both an unpleasant bowel prep before the procedure and a day off work to recover. Stool-based testing may be a more viable option for many patients, but the Centers for Disease Control and Prevention (CDC) and other groups have found that raising rates of screening also requires a shift to actively identifying and reaching out to patients who are not up-to-date.

Shivan Mehta, MD, MBA, associate chief innovation officer at Penn Medicine, had been worried offering patients a choice would overwhelm patients. “As a physician, if I talk to a patient, I can explain to them the pros and cons of different testing,” Mehta said. “But it may not be that easy to talk about those two different approaches when you’re mailing letters to people.”

For Mehta, the key to success was simplicity: “Making it really easy for patients to participate, whether it’s through sending them reminders, or mailing people fit kits, or making the scheduling process for completing colonoscopy easier.”