Eliminating colorectal cancer as a major public health problem

The University of Chicago Medicine Comprehensive Cancer Center, Goldblatt Pavilion

The University of Chicago Medicine Comprehensive Cancer Center, Goldblatt Pavilion

By Karen Kim, MD

Colorectal cancer is one of the most preventable cancers, yet it remains the third most common and the second deadliest cancer for both men and women in the United States. In the case of colorectal cancer, screening can find the disease at an early, more treatable stage, and it can also prevent it altogether through the detection and removal of precancerous polyps.

We know screening works; yet, only about 65% of people 50 and older have had some form of colorectal cancer screening, meaning about one-third of the population is not getting this important preventive care. In Illinois, the numbers are worse: in 2010, only 60% were screened, and among minority populations, the screening rates are even lower.

This presents an opportunity to not only educate people about cancer prevention and potentially save their lives, but also to reduce health care costs. According to the American Cancer Society, the costs for one year of treatment for a patient with late-stage colon cancer are as high as $310,000, with an estimated annual cost nationwide of $14 billion.

For these reasons, we have joined a national effort to improve colorectal cancer screening rates. Led by the National Colorectal Cancer Roundtable (founded by the American Cancer Society and Centers for Disease Control and Prevention), more than 140 organizations have committed to eliminating colorectal cancer as a major public health problem and are working toward a shared goal of increasing screening rates for adults age 50 and older to 80% by 2018.

Because prevention is critical to making progress against this disease, we think it’s important to let people know about their options when it comes to screening. In addition to colonoscopy, other methods include flexible sigmoidoscopy, fecal occult blood test, fecal immunochemical test (FIT), CT colonography, barium enema, and a more recent technique known as virtual colonoscopy.

Colorectal cancer screening is covered by most private insurance plans and those offered through exchanges under the Affordable Care Act’s preventive services section, usually without out-of-pocket costs.

Education and awareness are an important part of increasing screening rates. At the University of Chicago Medicine Comprehensive Cancer Center (UCCCC), we are hoping to make a big impact by working closely with the most vulnerable at-risk populations, such as our surrounding African-American community. Incidence rates and death rates from colorectal cancer are higher among African-Americans than among any other ethnic or racial group in the United States. Research here is exploring the biological, genetic, socioeconomic and behavioral factors that contribute to this gap.

Our Office of Community Engagement and Cancer Disparities has partnered with local organizations to develop culturally adapted programs that encourage those at risk in the African American, Hispanic and Asian American communities to get screened for colorectal cancer. Among our initiatives is a two-year partnership with the American Cancer Society to increase our screening capacity and help uninsured and underinsured individuals receive colonoscopies and follow-up care, as well as a walk-through program that brought in community members to see first-hand what getting a colonoscopy is like at our facility.

We are excited to be part of a nationwide push for more colorectal cancer screening, and by 2018, we certainly would love to see colorectal cancer death rates decline drastically.

Karen Kim colorKaren E. Kim, MD, is a professor of medicine, Dean for Faculty Affairs and director of the UCCCC Office of Community Engagement and Cancer Disparities. She specializes in the prevention, screening, and early detection of colorectal cancer, hepatitis B, and women’s health issues. Her research explores optimal ways to increase dissemination of health information into minority communities. Her research interests include underserved and minority populations, understanding health disparities, cultural competency, and cancer prevention.

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