Each year, over 2,400 Minnesotans are diagnosed with colorectal cancer – and, sadly, more than 800 die from it, according to the American Cancer Society (ACS). Colorectal cancer is the second highest cause of cancer deaths in the United States – even though it’s 90% treatable if caught early.
That’s why getting screened for colon and rectal cancer is so important. The ACS says regular screenings should start at age 45, but people who are considered high risk for colorectal cancer might start screenings before age 45. In healthy individuals, regular colorectal cancer screenings typically go until age 75.
In Minnesota, only 71% of the adults who have reached these ages are getting timely screenings according to Minnesota Community Measurement (MNCM) data. And screening rates among populations of color are even lower at 59%.
Some people often put off a colorectal cancer screening because they don’t want to have a colonoscopy. But the good news is that there’s another screening option called the FIT test – and it’s a test that you can do at home. The following story is a great example of how you can start with this less-invasive type of screening for colon and rectal cancer.
Annette’s colon cancer screening story
(To protect the patient’s privacy, a fictitious name is being used)
Annette is a 61-year-old African American woman. She is physically active, works full time and has three grown kids. She’s also a HealthPartners patient.
Every year for the past 10 years, her doctor has recommended a colonoscopy to screen for colon cancer. And each year, Annette has politely declined. She had heard from friends and relatives that colonoscopies (and the preparation for a colonoscopy) can be uncomfortable. Besides, Annette was healthy and no one in her family ever had colon cancer or polyps. So, did she really need a colonoscopy?
The truth about colonoscopies
Getting a colonoscopy is the best way to find colon and rectal cancer early, when it’s most treatable. But there are reasons why some people are hesitant to get screened.
To prepare for a colonoscopy, you need to take steps to clean out your colon, which requires using laxatives and being on a clear liquid diet for a full day beforehand. There can also be some discomfort during the colonoscopy exam as carbon dioxide is pumped into the colon to keep it open during the procedure. Plus, you need to find someone to drive you to and from the clinic because of the relaxation medicine given during the exam.
Still, it’s worth getting a colonoscopy because it could save your life. But if you’re still not convinced, there are other options, like the FIT test.
Taking a screening step: Annette and her at-home FIT test
When Annette came into the clinic for her annual checkup this year, she again declined a colonoscopy. But when her doctor made a follow-up suggestion for a FIT test, which is short for fecal immunochemical test, she agreed to try it.
A FIT test works by looking for a specific type of blood in your stool. If the test finds no blood – which is what happens most of the time – your colon cancer screening is done for the year. But if there is blood in your stool, this can be a sign of cancer or another condition, and you’ll likely need a follow-up colonoscopy.
Annette took home the FIT kit, followed the instructions and mailed it to the clinic lab two days later. The next week she received her results, which showed some blood in her stool. With that information, Annette agreed to schedule a colonoscopy.
Annette’s follow-up screening
During the colonoscopy, Annette’s doctor found and removed a polyp. This growth had been the source of her bleeding. Thankfully, testing showed the polyp was not cancerous – but polyps can become cancerous over time.
Based on her colon cancer screening results, Annette won’t need another colonoscopy for five years. At that time, they’ll check to make sure that no more polyps have developed. And as of now, Annette says she plans to get one again at that time.
“It really wasn’t that bad,” she said.
How HealthPartners has been innovating our use of the FIT Test
2009: HealthPartners clinics begin mailing FIT tests to patients who elect them.
2014: Our Park Nicollet clinics begin routinely recommending the FIT test. In just 6 months, their colorectal screening rates increase by 7%. Among populations of color, screening rates improve even more – by 10%. This screening option shows promise of being a key to reducing disparities in colorectal cancer screening tests.
2015: Our HealthPartners clinics streamline their FIT screening process. Before, patients had to respond to a letter each year and say they agreed to complete a FIT again. So, HealthPartners cuts that letter from the process. They instead begin mailing an annual FIT test to anyone who has completed one in the past. That makes the test even more convenient for patients.
2017: Four Park Nicollet clinics pilot a new approach to mailing FIT tests. They try sending the test to any 50- to 75-year-old patient who has never before had a colon cancer screening. This results in FIT tests arriving for the first time in the mailboxes of 6,000 patients. About 25% of the tests were completed – and those clinics’ screening rates go up 6%.
HealthPartners clinics build on this pilot to reduce the racial disparity that exists in colorectal cancer screening. They try sending FIT kits specifically to 46- to 75-year-old patients of color who have never been screened for colon cancer. This results in 3,000 tests being mailed. And once again, about 25% of the tests are returned. This boosts screening rates by 3.5%.
2018: HealthPartners is named the Colorectal Cancer Organization of the Year for this work.
Today: Our organization is successfully screening for colon cancer in more than 60% of our patients of color who are eligible.
With many HealthPartners and Park Nicollet cancer clinics throughout the Twin Cities and western Wisconsin, the latest in cancer screening tests and treatment is always close to home.