New Survey Finds Colorectal Cancer Screening Underutilized

Tool helps physicians start the screening conversation

A Cleveland Clinic colon cancer risk assessment survey found that only 36 percent of more than 27,000 respondents were adherent with current colorectal cancer (CRC) screening. In addition, less than 10 percent of respondents stated they ate five or more serving of fruit, vegetables and grains per day and only about 25 percent undertook at least 30 minutes exercise four times per week.

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“Colon cancer has had significant decline in the U.S. since 1980 when CRC screening was first introduced, but these results show screening for the disease — and a healthy lifestyle — appear woefully underutilized,” says Carol Burke, MD, gastroenterologist and current President of the American College of Gastroenterology.

Dr. Burke and colleagues in the Sanford R. Weiss, MD, Center for Hereditary Colorectal Neoplasia created the online questionnaire to provide respondents information about their colorectal cancer risk, and how they can modify it by CRC screening and lifestyle and dietary changes. She and co-investigator David Dornblaser, MS, presented their findings at DDW 2017.

Our survey was created in order to increase patient awareness of their risks for CRC, explains Dr. Burke, “and the opportunities to diminish the risk, since the survey provides a call to action for patients.”

She adds: “Presenting our research to colleagues at DDW may help them target their patients with identified factors who are less likely to adhere to screening and encourage them to do so. Our next research is to determine if our tool enhanced patient’s adherence to the screening.”

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Key findings

The survey, which can be found at  digestive.ccf.org asks respondents about age, gender, ethnicity, height, weight, dietary factors, smoking history, physical activity level, personal and family history of CRC or polyps, and adherence to CRC screening.

In general, the results showed that those who are adherent to CRC screening are more likely to be white and female. They also have less exposure to cigarettes, eat more daily servings of a plant-based diet and exercise more than those who were not up to date with CRC screening.

The data also indicated that respondents with a first-degree relative with CRC and polyps were significantly more likely to adhere to screening: 35.7 percent were adherent compared with 19.4 percent of participants without an affected first-degree relative.

So far, about 29,000 people from around the world have taken the five-minute questionnaire. The mean age of the cohort was 48.1 years with 66 percent of respondents female and 34 percent male. In addition, 76.1 percent reported white ethnicity.

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A call to action

After completing the survey, participants get a score of average, or above average at low, medium or high risk of CRC based on reported personal and family history of CRC, polyps or both. They also receive a family tree showing their risk and a call to action outlining what age to start screening and how frequently it should be done.

“Our hope by providing this online assessment is that individuals could take it, print out the results with the call to action and take it to their physicians to start the CRC screening conversation,” Dr. Burke says. “In turn, physicians can look at this study, get a better understanding of which individuals have decreased participation in CRC screening and target them for better utilization.”