The future of cancer screening and primary care
On May 27, Dr. Allen Dietrich, the James J. Carroll Professor of Oncology at DHMC, gave a lecture on prospects for cancer screening and primary care over the next ten years. The focus of his lecture, he said, was reinforcing “action that moves forward recent and current activities from Norris Cotton Cancer Center to reduce the number of colon cancer deaths.”
Dietrich explained that there are 150,000 new colon cancer cases a year, with 50,000 yearly deaths. In the Upper Valley, only 60% of vulnerable individuals are screened regularly for colon cancer, and additional screenings could save up to 18,800 lives per year. He offered the surprising statistic that 6 people out of 100 will contract colon cancer in their lifetimes and 3 will die. Better screening, he suggested, would cut those numbers in half.
Several factors account for the inadequate rate of testing: multiple tests lead to confusion, some patients lack access to testing, colonoscopies are time-consuming, and some people do not follow up frequently enough for testing to be effective.
Dietrich discussed reasons that patients sometimes reported for not receiving screenings. For some, the failure stemmed from inattentive physicians who didn’t recommend the tests. Others cited time constraints, and some were simply afraid of the invasive procedures. These fears can be assuaged through public education, and making screening easier and less inconvenient will encourage better participation.
Not all the news is negative, however – several ongoing projects aim to help increase screening rates. Among the most promising of these is the NHCRCSP: the New Hampshire Colorectal Cancer Screening Project. The goal of the project is achieving a statewide screening rate of 80% for persons 50 and older. Using an ad campaign featuring billboards, public service announcements, and newspaper articles, the project hopes to cut regional colorectal cancer deaths by 50% – an admittedly ambitious goal. The project presents a chance to raise attention about the importance of colorectal cancer screening and highlight the role of personal responsibility in health care decision-making.
In addition to screening initiatives, exciting new testing techniques less invasive than colonoscopy, like CT Colonography, are emerging. Combined with increased awareness and more attention to follow-ups by primary care physicians, innovative new techniques show great promise for drastically decreasing colon cancer deaths.
Dietrich finished his lecture by responding to critics who suggest his goals are out of reach: “Is it the time for us to cut colon cancer deaths by half? Yes – yes, it certainly is.”