Patient adherence to colorectal cancer (CRC) screening guidelines remains suboptimal, particularly among minorities. Two new studies suggest ways to increase screening rates.
One study, by Moshe Shike, MD, of Memorial Sloan-Kettering Cancer Center, New York, and associates found that offering CRC screening during mammography visits is “an effective way of generating interest and initiating the process” in minority women. The results are reported online in Cancer.
CRC screening was offered to 2616 women attending the Breast Examination Center of Harlem, a community outreach program serving the primarily black and Hispanic Harlem community. The women were 50 years of age or older and had not had CRC or screening within the past 10 years.
Of the 2616 women, 611 (23%) were enrolled in the study, and 337 (55%) of those who enrolled went on to have a screening colonoscopy. Screening revealed adenomatous polyps in 49 (15%) women.
Lack of medical insurance was the major barrier to screening.
The results show, according to the authors, that offering CRC screening to minority women at the time of mammography and without a physician’s referral can expand screening. They note, however, that alternatives to traditional medical insurance are needed for those without insurance.
Providing the option of computed tomography colonography (CTC), or virtual colonoscopy, as an alternative to conventional colonoscopy is another way to improve screening rates, a study reported in the November issue of the American Journal of Roentgenology suggests.
In the study by Fouad J. Moawad, MD, of Walter Reed Army Medical Center, Bethesda, Maryland, and associates, 250 consecutive average-risk patients undergoing CRC screening completed a survey that assessed reasons for choosing CTC instead of colonoscopy, compliance with CRC screening if CTC were not offered, and which of the two tests they preferred.
Convenience was the most common reason respondents gave for choosing CTC (33.6%), followed by recommendation by referring provider (13.2%) and perceived safety (10.8%). Of the 250 patients, 91 (36%) said they would have foregone CRC screening if CTC had not been offered. Of the 57 patients who had experienced both procedures, 95% preferred CTC.