San Diego’s Medical Community Pushes Colorectal Cancer Screening
Wednesday, March 21, 2018
Credit: Matt Bowler
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.
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.
The effort to get more people screened for colorectal cancer is starting to have positive results in San Diego.
To view PDF documents, Download Acrobat Reader.