While we seem to be years away from any sort of cure for cancer, a study shows promise for reducing mortality. A 20-year research initiative by Kaiser Permanente shows a spike in early diagnosis and a decline in overall deaths.
With multiple methods of detection, more people are being diagnosed earlier, thus increasing their chances of survival. With the options of colonoscopy, sigmoidoscopy, and fecal immunological testing (FIT), there has been an increase in diagnoses, many at earlier stages.
According to the study, these options give Black people a chance of survival.
Colorectal cancer is the second leading cause of cancer deaths in the U.S. Screening programs create an opportunity to find colorectal cancers when they are small and easier to treat. Screening can also prevent cancers from developing through the removal of precancerous polyps.
“By offering an effective screening approach equally to everyone, we were able to eliminate much of the disparity,” said lead researcher Douglas Corley, MD, PhD, from the Kaiser Permanente Division of Research in Northern California.
Corley states that ten years ago, a large gap existed between risk and outcomes, which negatively impacted Black people. A major factor is that Black people have a lower rate of screenings compared to other races.
Some reasons for fewer screenings include: lack of doctor referrals, fear, embarrassment of the procedure or preparation, and overall mistrust in the medical community. Black men are less likely than Black women, with the added feeling that the procedure makes them less manly.
Kaiser Permanente Northern California researchers used data from 1.1 million adults across their medical centers from 2000 to 2019. Starting in 2007, the hospital system started reaching out to patients who were overdue for colon cancer screening and sent them fecal immunochemical testing (FIT) kits to collect specimens at home.
The screening does not end with the collection of the specimen. If it does indeed show hidden blood in the sample, then the patient needs to pursue further testing.
These efforts led to screening rates doubling across all ethnic groups, and diagnoses rose early but then dropped by 30%. Deaths decreased by 50%, with Black patients seeing the largest reduction.
Black patients suffer due to a variety of factors, including access to healthcare, but the causes of colorectal cancer need further studying.
“We’re not treating the root causes. We don’t know if it’s diet, exposures, or something else, but by making screening available to everyone, we were able to level the playing field,” Dr. Corley states.
He credits flexibility for the outcomes, saying, “To get above an 80% screening rate, you almost always have to offer people multiple options.”
Citations
Ajufo A, Adigun AO, Mohammad M, et al. Factors Affecting the Rate of Colonoscopy Among African Americans Aged Over 45 Years. Cureus. 2023;15(10):e46525. Published 2023 Oct 5. doi:10.7759/cureus.46525
https://divisionofresearch.kaiserpermanente.org/colorectal-cancer-screen-program/