Colon Cancer Screening among Patients Receiving Dialysis in the United States: Are We Choosing Wisely?

Abstract Background Adherence to colorectal cancer screening in the United States is suboptimal, particularly in medically underserved populations due to significant barriers to care. Unique accessible, low-cost, and non-invasive screening tests for this population could greatly benefit current rates. In this article, we assess patient preference and the impact of offering a blood-based test on screening rates in a cost-free health fair setting from April 2017 to April 2019. Methods Participants who met colorectal cancer screening eligibility criteria set forth by the United States Preventive Services Task Force were recommended to attend the colon cancer screening station. Those participants who elected to attend were offered various, accepted screening methods, and if they declined, were offered alternative blood-based testing. Screening rates, test outcomes, and the rate of follow up completion of colonoscopy were measured and compared with historic screening outcomes. Results Of 1401 participants who were recommended to attend, 640 (45.7%) participants were evaluated at the colon cancer screening station, of whom 460 were eligible for testing. Amongst these, none selected colonoscopy, 30 (6.5%) selected fecal immunochemical testing, and 430 (93.5%) selected blood-based testing. Only 2 participants returned the fecal immunochemical tests. In the blood test cohort, 88 were positive and 20 received a follow up colonoscopy. Conclusions Based on this assessment, blood-based testing is an effective method to increase screening rates in medically underserved populations, though efforts to further improve access to follow up colonoscopy are necessary.

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A Retrospective Analysis of Gender-Based Difference in Adherence to Initial Colon Cancer Screening Recommendations

Journal of Primary Care & Community Health ◽

10.1177/2150132720931321 ◽

2020 ◽

Vol 11 ◽

pp. 215013272093132

Author(s):

Jose Raul Valery ◽

Andres Applewhite ◽

Alyssa Manaois ◽

John Dimuna ◽

Taimur Sher ◽

...

Keyword(s):

Colon Cancer ◽

Cancer Screening ◽

Physical Examination ◽

Odds Ratio ◽

The United States ◽

Colon Cancer Screening ◽

Crc Screening ◽

Significant Difference ◽

Males And Females ◽

Gender Based

Background: Colorectal cancer (CRC) is the fourth leading cause of cancer-related death in the United States, despite being largely preventable and treatable. Improving overall screening rates among both men and women is considered an important and effective strategy toward reducing morbidity and mortality from CRC. In order to optimize screening strategies, factors associated with decreased compliance need to be understood. This study aimed to compare initial CRC screening rates between males and females in a population of patients who presented for an annual physical examination. Methods: A retrospective chart review study of 380 patients designed to compare rates of initial CRC screening between males and females was conducted. Patients who were seen at our institution for an annual physical examination and were between 51 and 60 years of age were included. Results: There was no evidence of a difference in the rate of initial colon cancer screening between females (83.0%) and males (80.9%) in either unadjusted analysis (odds ratio = 1.16, P = .59) or in multivariable analysis adjusting for potential confounding variables (odds ratio = 1.16, P = .61). Conclusions: There was no significant difference in the rate of initial CRC screening between males and females who presented for an annual physical examination. This suggests that designing interventions to improve screening specific to gender may not be needed in a population of patients who attend routine preventive health examinations. Further study is needed in the general population to examine for gender-based differences in initial CRC screening among patients who do not regularly follow up for preventive examinations.

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Internet Interest in Colon Cancer following Chadwick Boseman’s Death (Preprint)

10.2196/preprints.27052 ◽

2021 ◽

Author(s):

Hiten Naik ◽

Maximilian Desmond Dimitri Johnson ◽

Michael Roger Johnson

Keyword(s):

Colorectal Cancer ◽

Colon Cancer ◽

Cancer Screening ◽

The United States ◽

Colon Cancer Screening ◽

Black American ◽

Online Activity ◽

The Public ◽

Search Terms ◽

The Impact

BACKGROUND Compared to White Americans, Black Americans have greater incidence and mortality rates from colon cancer, but lower up-to-date screening rates. Chadwick Boseman was a prominent Black American actor who died of colon cancer on August 28, 2020. As announcements of celebrity diagnoses often result in an increased awareness of particular conditions, Boseman’s death may have resulted in greater online interest in colon cancer. OBJECTIVE The objective of this study was to quantify the impact Chadwick Boseman’s death on online search interest in colon cancer, and thereby identify an opportunity for healthcare providers to educate the public and advocate for higher risk groups. METHODS We used Google Trends (GT) and Wikipedia pageview analysis to assess the change in online activity related to colon cancer in the United States from two years prior to Chadwick’s death to three months following the announcement of his death. We used two of GT search topics (“colorectal cancer” and “colon cancer screening”) and fifteen search terms related to colon cancer screening, symptoms, diagnosis and risk factors. We forecasted what RSVs and number of pageviews would be expected if his death had not occurred, and compared this to what was observed. The forecasts were generated with 95% bootstrapped confidence intervals (CIs) using the ARIMA algorithm in R software. RESULTS GT’s observed RSVs for the topics “colorectal cancer” and “colon cancer screening” increased by as much as 598% and 707%, respectively, and were on average 121% (95% CI, 72%-193%) and 256% (95% CI, 35%-814%) greater than expected during the first three months following Boseman’s death. Ten out of fifteen search terms had mean observed RSVs significantly higher than expected within the first and second month following Boseman’s death. Three of the fifteen search terms (“colon cancer signs”, “colon cancer survival” and “colon cancer symptoms”) remained significantly greater than expected within the third month following August 28, 2020. Daily Wikipedia pageview volume during the two months following Boseman’s death was on average 1,979% (95% CI, 1,375%-2,894%) greater than expected. Altogether, it is estimated that this represented 547,354 (95% CI, 497,708-585,167) excess Wikipedia pageviews beyond what would be expected if Boseman’s death had not occurred. CONCLUSIONS There has been a significant increase in online activity related to colon cancer following Chadwick Boseman’s death. This reflects a heightened public awareness that can be leveraged to further educate the public, including the high-risk Black American subgroup. The magnitude and duration of increased Google searches and Wikipedia pageviews following Boseman’s death is unprecedented in the literature and future research will reveal if this translates to improved screening and detection rates for colon cancer.

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