How CRCs will improve patient and physician relationships

     Colorectal Cancer (CRC) has become the third most prominent diagnosed cancer in the United States. Notably, it also became the second common cause of mortality in both men and women (Yu, Christine et al.,). It has become evident that there has been a recent decline in incidence and mortality rates mostly due to public health and screening efforts that have been put in place. According to the National Colorectal Cancer Roundtable (NCCRT), the goal is to have 80% Americans screened, however the current percentage is 65% for eligible adults between the ages of 50-75 years. With this goal in mind, the Multi-Society Task Force (MSTF) recommended fecal immunochemical test (FIT) and colonoscopy as first tier screening tests (Yu, Christine et al.,). The significance of providing these first tier screenings would be beneficial because it would encourage health care systems that offer low-cost and convenient modalities. Another rationale behind UCLA’s study and efforts that would be beneficial is that the recent screen rates range from 26% in large health systems, however the gastrointestinal team (GI) was invested not only in improving screening rates, but also improving system support to their patients who range from diverse populations.  

    The implemented multi-modal intervention to increase CRC screening rates among managed care patients at UCLA resulted in an increase from 65.1% to 76.6% which is closer to the goal of 80% screening rates prompted by the NCCRT. A reasoning behind the increase was due to a significant push for outreach and intervention from the GI team. This meant more physician to patient outreach that was beneficial to patients who received a positive FIT test that concluded a diagnosis of non-advanced adenomas, advanced tubular adenomas, and rectal adenocarcinoma. In this case, patients who did have a positive FIT test received greater follow-up the GI team to schedule a colonoscopy procedure, a process that can take long to secure. In another study conducted by UCLA’s GI team amid the COVID-19 pandemic concluded that the use of CRC screening will allow for more targeted utilization of precious health system resources.

The strategic plan from UCLA’s GI department and research team will forward the relationship between physicians and patients by expanding on the essence of underserved communities. Seemingly, to note that colorectal cancer can be traced much earlier to establish therapeutic strategies for patients at an earlier stage is crucial. My experience with trying to get treatment for GI issues was time constraining. It was very difficult to even schedule an endoscopy or colonoscopy for progression even after my diagnosis, so to see the increase of patients returning for care is promising. I think it would be interesting to look at young adults and if there would be any significant difference in the approach physicians take and the response of early screening.

Sources:

Myint, Anthony et al. “Noninvasive Colorectal Cancer Screening Tests Help Close Screening Gaps During Coronavirus Disease 2019 Pandemic.” Gastroenterology vol. 161,2 (2021): 712-714.e1. doi:10.1053/j.gastro.2021.04.026

Yu, Christine et al. “A Multi-Level Fit-Based Quality Improvement Initiative to Improve Colorectal Cancer Screening in a Managed Care Population.” Clinical and translational gastroenterology vol. 9,8 177. 4 Sep. 2018, doi:10.1038/s41424-018-0046-z