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San Diego's Medical Community Pushes Colorectal Cancer Screening

Dr. Daniel Anderson visits with colorectal cancer survivor Walter Roussell, March 7, 2018.
Matt Bowler
Dr. Daniel Anderson visits with colorectal cancer survivor Walter Roussell, March 7, 2018.

Walter Roussell had always been in good health. So he wasn’t expecting anything unusual when he had a routine colonoscopy about six years ago.

“I had never had any disease before," he said. "So it was kind of shock, to find out that you have something, and it wasn’t just a polyp that could be taken out. This was something that went a little further than that.”

Roussell was diagnosed with stage 3 colorectal cancer. He couldn’t believe it.

“I had no symptoms," he recalled. "So that’s what made it a little more difficult for me.”

Dr. Daniel Anderson, a gastroenterologist at Kaiser Permanente, said over his medical career he's performed 40,000 colonoscopies.

Anderson said during a colonoscopy, he’s looking for small polyps.

“Most colon cancers start from polyps. Most polyps won’t become colon cancer, but we take them all out, especially the big ones," he said. "The ones over a centimeter have about a 10 percent chance to go to colon cancer in 10 years.”

Anderson has been leading the efforts to get more San Diegans screened for colorectal cancer.

The initiative is starting to pay off.

San Diego's Medical Community Pushes Colorectal Cancer Screening

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On average, between 70 and 80 percent of San Diegans insured through commercial plans or Medicare are getting screened.

Anderson said because of that high screening rate, more people in San Diego County are getting diagnosed when their cancer is at an early stage.

“As a result, in San Diego County, you’re less likely to get colon cancer because of the polyps that are removed through the screening process, and you’re also less likely to die of colon cancer than the rest of California,” he said.

Mortality rate declined by 14%

According to the Cancer Registry of California, the incidence of colorectal cancer in San Diego County declined by 10 percent between 2010 and 2014, while the mortality rate declined by 14 percent.

However, the colorectal cancer screening rate among San Diegans who get their care in community clinics is only 46 percent.

Clinics are using a variety of methods to increase that rate.

On a recent weekday afternoon at the Imperial Beach Health Center, Medical Director Eric Leute, with a medical assistant, went over a list of the patients who are waiting to be seen.

“And we did give her a colon cancer screening card, so we should see if she’s turned those in yet, they haven’t been submitted yet. And for the next patient as well, he’s do for the colon cancer screening," he said.

For each patient, Leute checks to see if they have had a colorectal cancer screening.

Other ways to screen for colorectal cancer

Leute and his staff also send text messages to patients.

“Where we send the messages, educating them about colon cancer screening itself, colon cancer, the different methods of screening, so it takes some of the fear away from the patients, so they know what they’re getting involved with, and how easy the screening is to do," he said.

It turns out colonoscopies aren’t the only way to screen for colorectal cancer.

There’s also something called a fecal immunochemical test, or FIT, that screens for hidden blood in the stool. That test can be done at home and mailed to a lab.

Anderson said both tests reduce colon cancer incidence and mortality by about 70 percent.

“So, either test is excellent," he said. "The important thing is to get screened."

Screening saved Walter Roussell’s life.

After he was diagnosed with cancer, he went through chemotherapy, radiation and had a portion of his colon removed.

He’s been cancer-free for six years.

“All the radiation and chemotherapy pretty much cured me. So that helped me out a lot, knowing that what I went through was worth it,” Roussell said.

The American Cancer Society estimates 140,000 people will be diagnosed with colorectal cancer in the United States this year.

Some 50,000 Americans will die from it.

San Diego’s Medical Community Pushes Colorectal Cancer Screening
The effort to get more people screened for colorectal cancer is starting to have positive results in San Diego.

>> This is KPBS mid-day addition I am Michael Lipton then. Over the last few years Sandy goes medical community has made an effort to get people screen for colorectal cancer the second leading cause of cancer death and it is the only type of cancer doctors can prevent by screening. >> Walter cell had always been in good health so we wasn't expecting anything unusual when he had a you routine colonoscopy six years ago. >> I had never had any disease before. So it was a shock to find out that you have something and it wasn't just a polyp that could be taken out. This was something that was further than that. >> He was diagnosed with stage III colorectal cancer. >> I had no symptoms so that's what made it more difficult for me. This is the scope that has just come out from the procedure to keep it clean and ready for the next use and we can move the tip. >> Dr. Daniel Anderson is a gastroenterologist at Kaiser Permanente. The colonoscope is the tool he uses to examine the inside of the colon. He explains that during the colonoscopy he is looking for small polyps. >> Most: cancers start from polyps and most polyps do not become colon cancer but we take them all out especially the big ones have about a 10 percent chance to become colon cancer in 10 years. >> Anderson has been leading efforts to get more San Diego and screened. The initiative is starting to pay off. On average between 70 and 80 percent of San Diego's insured through commercial plans and Medicare are getting screen. Anderson says because of that high screening rate more people in San Diego County are getting diagnosed when the cancer is at an early stage. >> As a result in San Diego County you are less likely to get colon cancer because of the polyps removed through the screening process and you are also less likely to die from colon cancer. >> According to the cancer registry of California the incidence of colorectal cancer in San Diego County declined by 10 percent between 2010 and 2014 and the mortality rate declined by 14 percent. However, colorectal cancer screening rate among San Diego to get their care in community clinics is only 46 percent. Clinics are using a variety of methods to increase that rate. >> We did get colon cancer screening cards and our next patient as well. >> At Imperial Beach health center Eric Lloyd to goes over a list of patients waiting to be seen. For each patient Dr. Like the checks to see if they have had their colorectal cancer screening. He and his staff send text messages to patients. >> We sent texts encouraging them about Kohler screening and different methods of screening so it takes some of the fear away from the patient so that they know what they are getting involved with and how easy it is to do. >> It turns out colonoscopies are not the only way to screen for colorectal cancer pictures of also something called an FIT test that screens for hidden blood in the stool and that can be done at home and mailed into a lab. Dr. Anderson says both tests reduce cancer incidence and mortality by 70 percent. So I detest is excellent and the important thing is to get screen. >> Screening saved Walter Lou sells life after he was diagnosed with stage III he went through chemotherapy, radiation and had a portion of his Colon removed. Today he is cancer free for six years. >> All of the radiation and chemotherapy pretty much cured me. That helped me out a lot knowing that what I went through was worth it. >> The American Cancer Society estimates 100 30,000 people will be dying most with colorectal cancer in the U.S. this year. Some 50,000 Americans will die from it. Kenny Goldberg KPBS news.