BY GRANT CRAWFORD
Zooming in
Moving forward
impacting Texas’ low rate, said Dr. Navkiran Shokar, chair of the Department of Public Health at Dell Medical School. Shokar is leading an initiative called the Coor- dinating Center for Colorectal Cancer Screening across Texas, meant to create a statewide network of health organizations and develop a plan for expanding screening resources. Shokar said it can be difficult for people to find a physician, arrange a timely screening, receive test results and book a follow-up colonoscopy. “We want to help facilitate the clinical systems to support screenings, testing and treatment,” Shokar said. “We also have to work on education for patients, so they understand the need for screening and know where the resources are.”
Texas ranks 45th for the rate of people between 45-75 who have received a recommended colon screening, according to the most recent NCI data. The Affordable Care Act requires private insur- ers and Medicare to cover the cost of colorectal screenings because the tests are recommended by the U.S. Preventive Services Task Force. However, the task force recommends people at average risk begin screening at 45, and patients are still likely to incur costs for services related to the procedure. “I think we would all be really happy to hear that screening number moved to 40, but that’s a big foundational shift amongst a lot of bureaucra- cies, but hopefully over time the data will support that,” Miller said. Access to health insurance is just one factor Screening rates In 2022, the percentage of people between ages 45-75 who received a recommended colorectal screening in the U.S. was 66.9%. Texas, ranked 45th among states, had a rate of 61.4%. Connecticut had the highest rate at 75.3%. Percentage of people that received at least one recommended CRC test in 2022 **
Dr. Judith Amaning, section chief for gastroenterology for Baylor Scott & White Health in Round Rock and Pflugerville, said colonoscopies are the “gold standard.” During the procedure, doctors can locate and remove potentially cancerous polyps. “You don’t want to wait 10-plus years to get screened and then instead of something small that can be removed within 20-30 minutes, now you have to have surgery,” said Amaning. According to a 2021 report by the UPSTF, the estimated number of colorectal cancer cases averted per 1,000 individuals who begin screening at age 45 ranges from 42-61 cases.
Steps to mitigate risk of colon cancer
Get screened
Maintain a healthy weight
Stop smoking
55.5-62.5% >67.6-70.3%
>62.5-65.5% >70.3-75.3%
>65.5-67.6%
Limit alcohol
**95% CONFIDENCE INTERVAL
Texas ranks 45th in screenings
Limit red meat to two meals a week Eat more whole grains and fiber
Types of colon screenings
Fecal immunochemical test (FIT): A test to check for hidden blood in stool
Blood test: Requires a blood draw to detect the presence of cancer
Sigmoidoscopy: Used less often to exam the lower part of the colon
Colonoscopy: Checks the entire colon and can remove polyps
Virtual colonoscopy: Uses x-rays and computer to create images of the colon
SOURCES: TEXAS ONCOLOGY, CENTERS FOR DISEASE CONTROL AND PREVENTION/COMMUNITY IMPACT
SOURCE: AMERICAN CANCER SOCIETY, NATIONAL CANCER INSTITUTE/COMMUNITY IMPACT
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