March was National Colon Cancer Awareness Month, which has been a great opportunity for gastroenterologists to increase awareness about colon cancer. This is an important issue to highlight because colon cancer is the fourth most common cancer and the second leading cause of cancer deaths in the U.S. It is estimated that every year about 140,000 Americans are diagnosed with colon cancer and another 50,000 will die from the disease.

These numbers are too high, as colon cancer can be highly preventable with the appropriate screening measures. I know from patients I see in my practice at Montefiore Medical Center that many patients are unaware of their options for screening and have little insight that this disease can be avoided. I have diagnosed colon cancer far more often than I would have liked in patients where I wonder if they had been screened earlier, the disease could have been prevented.

One in three adults — almost 23 million Americans between 50 and 75 years old — are not getting tested for colon cancer as recommended. According to the American Cancer Society (ACS), the colon cancer death rate in this country could be cut in half if Americans followed recommended screening guidelines.

How can we make an impact on screening rates? Public health awareness campaigns serve an important role. This includes public education campaigns with advertisements on billboards, public spaces, or public transportation. For example, on March 31, along with our gastroenterology department, Montefiore Einstein Center for Cancer Care will host the Rollin’ Colon, a 20-foot inflatable colon for community members to walk through and learn about polyps and the importance of regular screenings.

There are many opportunities for events such as footraces, walks, or health fairs to raise awareness. In major urban centers such as New York City, colon cancer screening information has been made available through 311, the same number that a city resident would call with questions about a parking meter malfunction or pothole repair.

Aside from general efforts at raising public awareness, one of the key ways to increase the number of patients getting screened is a partnership between the gastroenterologist and primary care practitioner to educate and encourage patients to pursue colon cancer screening. Primary care is the front line for patient care and these practitioners are in frequent contact with patients dealing with urgent or chronic care needs along with discussing appropriate screening exams.

Gastroenterologists can partner with their primary care colleagues in several ways to help educate their patients about colon cancer screening.

First, gastroenterologists can provide educational opportunities with lunch talks or grand rounds to educate primary care practitioners on up to date screening and surveillance recommendations. Additionally, gastroenterologists should help provide easy and seamless ways for the primary care practitioners to refer patients for consultation and evaluation without prolonged wait times for appointments.

Gastroenterologists can also provide many resources for their primary care colleagues to help with patient education by directing them to many free online resources available through the prestigious societies in the U.S. such as the American College of Gastroenterology (ACG), American Gastroenterological Association (AGA) and theAmerican Society of Gastrointestinal Endoscopy (ASGE), as well as cancer societies including ACS and other national groups such as the National Colorectal Cancer Roundtable (NCCRT). These include handouts in various languages, graphics and images to post in the clinician’s office, as well as videos and online interactive resources for patients to help educate them about colon cancer screening.

Another way healthcare practitioners can collaborate to improve colon cancer screening is to participate in direct colonoscopy referral programs. For example, Montefiore Einstein Center for Cancer Care encourages the use of direct referrals for colonoscopies. Primary care practitioners within the Montefiore Health System can click a button in their electronic medical records to refer a patient for a screening colonoscopy exam, should the person fulfill specific criteria.

These programs allow primary care practitioners to directly refer a patient for a screening colonoscopy exam if the patient fulfills specific criteria without having to be seen in the office first by a gastroenterologist. Patients with few or no comorbidities can get fast-tracked for screening colonoscopy exams while enthusiasm and willingness are still fresh, as opposed to waiting several months for an office visit with a gastroenterologist and then scheduling the exam.

The ACS and the NCCRT created an ambitious public health initiative energized by the call of “80% by 2018” which is a goal set to screen 80% of eligible adults in the U.S. for colon cancer by 2018. Many organizations including the ACG, AGA and ASGE have committed to this pledge, but the logistics for accomplishing this goal will hinge on the gastroenterologist’s partnership with primary care. Working with primary care is one of the most important things that gastroenterologists can do to increase rates of colon cancer screening in hopes of effectively eliminating this highly preventable disease.

• ASGE — colon cancer awareness information —http://www.screenforcoloncancer.org/
• AGA — colon cancer awareness information —http://www.gastro.org/community/colorectal-cancer-awareness-month
• ACG — colon cancer awareness — http://gi.org/acg-institute/colorectal-cancer-awareness/
• NCCRT — Provider Education for colon cancer awareness —http://nccrt.org/about/provider-education/
• MECC — Montefiore.org/Cancer
• NCCRT — 80% by 2018 — http://nccrt.org/tools/80-percent-by-2018/