Many Patients Not Getting Follow-up Colonoscopy
Statistics estimate about one in every 20 people will be diagnosed with colorectal cancer in their lifetime.
CRC is a leading cause of cancer death in the U.S., but the disease may be prevented through timely screenings.
Several colorectal cancer screening options are available. Many individuals choose a noninvasive, stool-based test they can do at home. These tests are convenient, but they cannot diagnose polyps or tumors, and they cannot prevent CRC development.
Experts advise anyone who receives an abnormal stool-based test result to follow-up with a colonoscopy within six months.
Failing to get a follow-up colonoscopy or delaying the procedure is associated with an increased risk of colon cancer, as well as having the disease present at a more advanced stage.
CRC complications, mortality risk increases
Jeff T. Mohl, PhD, from the American Medical Group Association in Alexandria, Virginia, and colleagues conducted a mixed-methods cohort study, recently published in JAMA Network Open.
The study population included 32,769 Black, White, Asian and Hispanic patients aged 50 to 75 years who were considered at average risk for the disease. The data was collected between June 1, 2015, and June 30, 2021.
The study revealed 49 percent of patients who received abnormal stool-based test results did not follow up with a colonoscopy within six months. Only 56.1 percent of patients completed a follow-up colonoscopy within a year.
Researchers noted a significant decrease in follow-ups during the early COVID-19 pandemic. Patients who were Black or Asian, those on Medicare or Medicaid, and those who chose a fecal immunochemical test (FIT) (vs. mtDNA) had lower follow-up colonoscopy rates.
“At-home stool-based testing offers a useful tool to supplement routine colonoscopy and reach a wider patient population,” the researchers advised. “Nonetheless, it is important to emphasize that all positive stool-based tests must be followed by a timely colonoscopy to complete the screening paradigm.”
Get screened at age 45
The American Cancer Society (ACS) estimates 153,020 people will be diagnosed with colorectal cancer, and 52,550 people in the U.S. will die from the disease this year.
If you are 45 and at average risk for CRC, ask your doctor about getting screened for colorectal cancer. Earlier screening is advised for patients with a family history of CRC or polyps, as well as those with digestive symptoms that may be caused by CRC.
The five-year survival rate is about 90 percent when colorectal cancer is found at an early stage before it has spread to other organs.
Although it is more invasive than other screenings, colonoscopy is the only screening method that can both detect and prevent CRC. Colorectal cancer often begins as a growth, called a polyp, inside the colon or rectum. Colonoscopy involves a complete examination of the colon where doctors can find and remove polyps before they become cancerous.
“Not completing a colonoscopy after a positive (stool-based test) is associated with a significantly higher risk of CRC complications and mortality,” authors of the study reported.
For your health, ask your doctor about getting screened for colorectal cancer. Whether you need to schedule your first CRC screening or a follow-up colonoscopy, don’t delay this life-saving procedure.