Electronic health records improve colon cancer screening rates
March 4th, 2013
05:01 PM ET

Electronic health records improve colon cancer screening rates

Centralized record-keeping systems may help improve rates of colon cancer screening, according to a new study.

Researchers at the Group Health Cooperative, a non-profit health care and insurance system in Washington state, used electronic health records to identify and monitor almost 5,000 patients who were due for a colon cancer screening but hadn't gotten it.

One group of patients received "normal care" - reminders from their doctor during appointments. A second group received a letter in the mail encouraging them to get screened; a third group got a call from a medical assistant on top of all of that, and a fourth group got a "patient navigator" to manage the screening process.

Each additional step increased the percentage of people who got screened, from 26% in the "normal" group to 65% in the patient navigator group.

"With a simple centralized program, we leveraged our electronic health records to identify those who needed screening," said Dr. Beverly Green, the lead study author and a practicing family physician at GHC. "We doubled the colon cancer screening rates."

Traditionally, Green says, colon cancer screening rates are much lower than with other cancers - namely breast and cervical cancers - largely because of one major factor: Convenience.

"You have to take off a day of work, maybe two. The prep is uncomfortable. You have to have somebody to drive you," said Green. "People don't like the idea of (colonoscopies); they're fearful of it."

But she said, colonoscopy wasn't the only screening option offered.

"While [patients are] mustering up their strength to have a colonoscopy, 5 years have passed, and in that period of time, they could be doing a stool card."

A stool card - also known as a Fecal Occult Blood Test (FOBT) - involves putting a small stool sample on a card and mailing it into a lab, where technicians look for trace amounts of blood.

Current U.S. Preventative Services Task Force recommendations say patients should do either a stool card each year, beginning at age 50; a flexible sigmoidoscopy every 5 years along with stool testing, or a colonoscopy every 10 years.

One major criticism of the study is that, although researchers were able to double screening rates, the number of colonoscopies - considered the most sensitive screening tool - actually went down.

"A lot more people did get screened," Green says, "but a few people, because we sent them a stool card, did that in place of a colonoscopy."

And she says while a stool card isn't as effective as a colonoscopy - it'll catch 75% of colon cancers, but very few, if any, pre-cancerous lesions - some testing is better than no testing.

"The best test for colorectal [cancer] screening is the test the patient will do, and one they'll keep doing on time."

soundoff (28 Responses)
  1. financeboomer

    Interesting study.
    Boomers, Markets & Money

    March 4, 2013 at 17:59 | Report abuse | Reply
  2. Keith Harancher

    How many more decades will it take for humans to get health CARE. Doctors do not practice preventive health care. Even Jiffy lube sends postcards reminders for my, truck preventive maintenance. My dog gets phone calls, birthday cards and email reminders all the time. My experience is that the doctors only care for the 15 minutes you get with them and the staff doesn't even follow up. For us loners we will never be able to get a colonoscopy. I think that Doctors should take a look at the professional healthcare model that most pets get even a pet snake or rat gets a belly scratch and a biscuit plus all those reminders.

    March 5, 2013 at 10:23 | Report abuse | Reply
    • Wrathbrow

      Your linking Jiffy Lube and colonoscopy made me smile.

      March 5, 2013 at 22:00 | Report abuse |
  3. mdf

    colonoscopy requires sedation, and a "responsible" other to be present for 24h. so 2 people off work. i've never seen one done on a sat. or sun., or even after 5pm. what happens if you don't have a responsible other? yes there are some of us who have no one to go with us to invasive testing. care is delayed for months if given at all. we are seen as "difficult" and "non compliant". phrases insurance companies use to drop us off the health care plan. there needs to be options for us single persons.

    March 6, 2013 at 01:38 | Report abuse | Reply
  4. MLS

    This is a great example of colorectal cancer screening rates increasing with the addition of risk appropriate "recommended screening options" for colorectal cancer screening, implementation of a patient reminder system, and assistance with navigation throughout the screening process. An annual FOBT/FIT is a recommended colorectal cancer screening option for an average risk 50-75 year old. There is no "one best test" screening test for everyone. With the addition of adding risk appropriate screening options, a choice, as well as the other components of the study, colorectal cancer screening rates increased. Great to see. YEAH!!

    March 6, 2013 at 11:49 | Report abuse | Reply
  5. MLN

    I am not that age but when I am, I won't be getting that test. I won't waste time off work for it and I won't do that disgusting prep. I would rather not know and live my life.

    March 6, 2013 at 19:47 | Report abuse | Reply
    • Hahahahahahahaha

      It shouldn't be too bad once they get past that peskly gerbil you have in there. Hahahahahahahahahaha

      March 8, 2013 at 09:29 | Report abuse |
    • HH

      I agree. Why do they insist that I get screened for a disease when I'm not interested in pursuing the treatment? I will not do chemo or radiation. The docs insist "you might change your mind." No, I won't. I made that decision after researching survival rates and watching friends and relatives go through cancer treatment. I don't think it's worth it. I've seen several people die from complications of chemo, not their cancer! Every time my decision is reinforced. Why waste my time and money on screenings?

      March 18, 2013 at 10:27 | Report abuse |
  6. Timmy Suckle

    Don't worry people. Pretty soon you won't be able to afford the test anyway. I kissed my way up to VP at a health insurance company. Now I take over $600,000 of your health care dollars for NO VALUE ADDED to your health care. And that’s just me. Now think about how many other VPs, Directors, Managers, etc. are at my company alone. Now multiply that by thousands of others at hundreds of other health insurance companies. From 10 to 25% of your health care dollars go towards administration that adds NO VALUE to your health care. But my company’s PAC dollars will continue to fool you little people into thinking that a single payer system will be bad. Little people like you are so easy to fool. Little people also don’t realize that a single payer system is the ONLY system that would allow little people (as an entire country) to negotiate better health care prices. Little people don’t realize that the Medical Cartels already know that. And that is the reason why the Medical Cartels spend so much PAC money from the hospitals and doctors lobbying against a single payer system. Some little people say that a single payer system would cost you little people more. But if that were true, then wouldn’t the hospitals and doctors WANT that extra money? Yes they would. So why do the Medical Cartels lobby against a single payer system? It’s because the Medical Cartels know it would allow little people to negotiate better health care prices. And that’s what the Medical Cartels are afraid of. Period.
    But us big wigs at insurance companies, hospitals, and pharmacy companies don’t ever need to worry about health care no matter what it costs. We get our health care paid for one way or another by you little people. And we get the little people that work at our companies to contribute to our PACs. And us big wigs say it’s to protect the little peoples’ jobs. But in reality it would be in the little peoples’ best interest to NOT contribute to the PAC. Again, little people are so easy to be fooled. I won’t ever have to worry about losing my job with so many little people being brain washed by the Medical Cartels’ PAC money. Not only that, the Medical Cartels’ PAC money is used to elect so many republicans that will never allow a single payer system. Republicans have always fought against any meaningful health care reform. But that’s what our Medical Cartels’ PACs pay them for. Politicians can be bought so easily.
    Pretty soon the only people that will be able to afford health care is us big wigs. And that’s the way it should be. We don’t want you little people using up the resources when we need them. And once again, I thank you little people for capping my SS tax at the $113,700 level. Now I only pay 1.2% SS tax and you little people pay 6.2%. Also, thank you for extending my tax breaks. I’m using the extra money on my vacation houses.

    March 7, 2013 at 13:50 | Report abuse | Reply
    • pal

      Inappropriate place for your rant.

      March 8, 2013 at 08:37 | Report abuse |
    • Hahahahahahahaha

      Hey Pal! Inappropriate? Really? It's spot on!!!!!!!!! Hahahahahhahahaha

      March 8, 2013 at 09:30 | Report abuse |
  7. Dave T

    I strongly suggest people get a colonoscopy. . As it pertains to my colonoscopy, they found 2 polyps that were pre-cancerous. Now I know i will not have to deal colon cancer. Though I have to have another colon test in just 3 years. If you have love ones, spouse, children or grandchildren, have this colon test for them. They should not have to experience you going through chemo due to colon cancer when it can be avoided!... I had another scare with cancer 13 years ago, as well. I had a lump checked early and had only 6 treatments of chemo back in 2000. I have been that cancer free ever since. I guess it was that I had this lump checked early that saved my life. So please, if you have a lump or cough or it is time for a colon test, have it done soon. Do not do these for you, but for your love ones instead. I will confirm, there is life for many years after cancer, if you have all health problems checked early or have those colonoscopy check ups!

    March 8, 2013 at 07:52 | Report abuse | Reply
  8. manik

    The whole employability industry should be disbanded. I've worked i it for over ten years now
    and can only see it as a complete sham. I got into it in order to help people but over the
    years it's become so very clear that all it is is about people and organisations helping
    themselves and using often quite vulnerable people as commodities to do so.

    March 21, 2013 at 08:02 | Report abuse | Reply
  9. hesham mostafa

    This is a genuine discovery in cancer research. A clinical trial disclosed that they managed to lower 3-year fatality in those with metastatic cancer malignancy by practically 5 times. Absolutely nothing is comparable to this effect in the overall oncological exploration. Once more 5 times fewer people passed away in three years once they applied one auxiliary therapy. The therapy took it's origin from the strategy employed by practically 200 Russian medical experts, and the goal of the therapy is to boost oxygen levels in body cells employing the famous Buteyko respiration technique. These spectacular outcomes are revealed and all details of their treatment are identified in the Amazon Kindle book “Doctors Who Cure Cancer”: Cancer by Dr. Artour Rakhimov. If you know anyone with cancer, feel free share!

    March 24, 2013 at 22:24 | Report abuse | Reply
  10. hesham mostafa

    This is a genuine breakthrough in cancer research. A clinical trial disclosed that they were been able to lessen 3-year fatality rate in people who had metastatic cancers by practically 5 times. Nothing at all is identical to this effect in the overall cancer research. I repeat 5 times fewer folks past away in three years if they employed one particular supplementary therapy. The therapy took it's origin from the strategy utilized by pretty much 200 Russian medical experts, and the objective of the procedure is to raise oxygen pressure in body organs utilizing the legendary Buteyko respiratory method. These stunning effects are revealed and all specifics of their therapy are outlined in the eBook from Kindle store on Amazon “Doctors Who Cure Cancer”: Cure cancer by Dr. Artour Rakhimov. When you see anyone with cancer, I ask you to share!

    March 24, 2013 at 22:38 | Report abuse | Reply
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    Most colorectal cancer occurs due to lifestyle and increasing age with only a minority of cases associated with underlying genetic disorders. It typically starts in the lining of the bowel and if left untreated, can grow into the muscle layers underneath, and then through the bowel wall. "*;:

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