East Oakland and Howard Daniel Staff Launch Colon Cancer Pilot

By Elaine Herscher, Senior Editor

Despite many innovations, colon cancer screening for LifeLong patients has remained frustratingly low. Last year, the modest goal of 40 percent of eligible patients screened for the disease remained out of reach.

This is troubling because excluding skin cancers, colorectal cancer is the third most common cancer in the United States. If caught early, the five-year survival rate for the disease is 90 percent.

While breast cancer screenings in March of this year exceeded the 70 percent goal (73.1percent) along with cervical cancer with a goal of 50 percent and an actual of 52.5 percent, colorectal cancer screenings were at only 28.4 percent with a goal of 35 percent.

“Colorectal cancer screening, from what I’ve seen, has continued to be one of our low- performing measures, within our core clinical quality measures,” says Anu Navuduri, LifeLong’s Director of Quality and Population Health.

Anu and her team have partnered with the American Cancer Society and Stanford University particularly to target screening for African American people, who have among the lowest numbers of patients accepting screening. LifeLong has offered rideshares to colonoscopies, financial incentives, and improvements in the FIT kits that have been the primary screening tools. They’ve sent hundreds of Well texts and letters reminding patients to do the screenings.

But now they are trying something new: staff at the Howard Daniel and East Oakland health centers have launched a pilot program offering Cologuard from Exact Sciences to patients.

If you ever watch daytime television, you’ve probably seen Cologuard advertisements. An

animated box with a happy face arrives on the doorstep offering discreet screening at home. Anu and Quality Improvement Coordinator Yesica Guzman say that Cologuard is less cumbersome to use than the FIT kits, more sensitive, and offers the advantage of needing to be repeated every three years instead of once yearly with the FIT kit.

“The collection is much easier compared to the FIT kit,” Anu says. Plus competed tests can be dropped off at UPS locations or picked up at patients’ homes. The instructions are also available in multiple languages.

The return rate of FIT kits has been low. People forget about them or lose them, and let’s face it, it’s hard to get motivated to do these tests. With Cologuard, Exact Sciences reminds patients to send in their test or will replace lost tests, taking the onus off of LifeLong staff.

Patients who have a positive result with either of the home test kits are then referred for colonoscopies. The test has taken on even greater significance because under the latest guidelines patients should start screening at age 45 rather than age 50.

Beginning last month, LifeLong patients turning 45 are receiving birthday screening reminders, and Anu’s team has launched an educational awareness message through MyChart and text messaging for patients between 45 and 49. Her team is working on making Cologuard tests available to all of LifeLong’s health centers.

“We’re hoping that all these advantages that Cologuard has will be a step in the right direction and will improve our performance rates,” Anu says.

Intranet picture: East Oakland Health Center Staff

Howard Daniel Health Center Staff