Physicians, insurers and others need to think globally, and seek novel moments that can be used to educate patients so they don't fall through the cracks, she adds. For instance, radiologists can take time during mammography appointments to educate women about their colon cancer risk, and to suggest they ask their primary care doctors whether it's time for a colonoscopy or other colon test. ACS guidelines call for women (and men) over 50 who have no elevated risk factors to have a colonoscopy every 10 years, or a sigmoidoscopy every five years, or a test of their feces each year.
To increase women's adherence to colon cancer screening guidelines, Carlos and her colleagues say, doctors offices, insurance providers and health systems will have to make organizational changes. From reminder postcards to dedicated clerical staff to educational materials, they note that there are substantial opportunities to boost rates of screening. There's also an incentive: a major health care quality rating system, known as HEDIS, has recently added rates of colon cancer screening to its report cards for health providers.
The fact that most women go for mammograms and Pap smears year after year is great, but getting them in the door for their first colonoscopy may hold even more life-saving value, adds Mark Fendrick, M.D., M.S., Carlos's co-author on the AJMC editorial and a professor of internal medicine.
"Many women undergo repeated testing for one disease, and completely neglect screening tests for other treatable cancers," he says. "We need greater emphasis on, at minimum, initial testing for multiple conditions. That will maximize the benefits of screening."
'"/>
Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
15-May-2004