Colorectal Cancer: Screening Can Be a Lifesaver
4/17/2013, 9:01 a.m.
BWH gastroenterologist Dr. Walter Chan, with patient navigator Oscar Sanchez, champions colorectal cancer screening by age 50.
A colonoscopy is an invaluable tool for helping to prevent colorectal cancer. So why doesn’t everyone get one?
Brigham and Women’s Hospital (BWH) gastroenterologist Walter Chan, MD, MPH, stresses that everyone should get screened for colorectal (colon or rectal) cancer by age 50. People with a family history of colorectal cancer should get a colonoscopy even sooner — at age 40 or earlier.
Unfortunately, many people fail to follow this advice, and the impact is significant. Colorectal cancer is the third leading cause of cancer deaths in Massachusetts, but it’s believed that more than 33 percent of these cases could be prevented if everyone over the age of 50 were screened.
Dr. Chan explains that there are a number of obstacles that discourage people from getting colonoscopies. The biggest issue appears to be a lack of understanding about the procedure. In addition to not knowing how to prepare for the procedure or not knowing what goes on during a colonoscopy, people fail to realize that the primary goal of the screening is to prevent cancer.
“Using the word ‘screening’ can be misleading to some people,” says Dr. Chan. He explains that the purpose of the procedure is not simply to determine whether a patient has cancer or not. The main goal of getting a colonoscopy when recommended is to look for pre-cancerous growths and then remove them to prevent cancer.
Other issues revolve around simply getting to the procedure and back home. Since patients are sedated for a colonoscopy, they need someone to accompany them to the procedure and then drive them back home afterward. Not only can it be difficult to find proper transportation, but it also requires finding a companion who would be available to spend several hours with the patient.
Breaking down these barriers is particularly important for African-Americans and Hispanics. African-Americans have a genetically greater risk of developing colorectal cancer (with some experts recommending that they start screening at age 45), and historically, members of both groups are less likely to get screened than people from other ethnic backgrounds.
To determine why people aren’t getting screened and then to eliminate those obstacles, the BWH Center for Community Health and Health Equity (CCHHE) has partnered with Dana Farber/Brigham and Women’s Cancer Center (DF/BWCC) to develop the Open Doors to Health - Colorectal Cancer Screening Program. The program currently serves patients at Brookside Community Health Center in Jamaica Plain and Southern Jamaica Plain Health Center.
A key feature of the program is the patient navigator, who helps guide patients throughout the entire colonoscopy process. From the time a patient is referred for a colonoscopy to the time they return home after a procedure, the navigator is available to help patients get around the challenges that discourage them from getting screened.
The patient navigator, who speaks English and Spanish fluently, provides numerous services to our patients, including: answering patient questions in person and over the phone, helping them obtain prescriptions and take medications properly, explaining how to prepare for a colonoscopy, arranging transportation, and sometimes even taking patients to the hospital and bringing them back home. The navigator also collects data about experiences with patients to help build a better understanding about the most difficult and most common obstacles, and how to successfully overcome them.
Making a Difference
A recent BWH study found that patients guided by the patient navigator were 65 percent more likely to successfully complete a colonoscopy procedure than patients who didn’t get the navigator’s help.
But Dr. Chan doesn’t need to see the numbers to know that the patient navigator is making a difference. “After they’ve talked to the patient navigator, a lot of their questions have been answered,” says Dr. Chan. “There’s less fear, there’s less anxiety, and I know that they’re going to show up.”
To learn more about the CCHHE’s colorectal cancer screening program, contact us at (617) 264-8750. And to learn more about what a colonoscopy is and why it’s important, please visit www.brighamandwomens.org/colonoscopy.