A simple technique to decrease the risk of developing colorectal cancer.

Of the cancers that both men and women can get, colon cancer is the second leading cause of cancer death in the Unites States.  Colonoscopy, when performed by an expert with an adequate adenoma detection rate, has been shown to reduce the risk of developing colorectal cancer.  For most people, routine screening colonoscopy is recommended starting at age 50.

scheduleLife has a funny way of getting in the way of a routine screening colonoscopy.  Despite the fact that the test saves lives, many people would rather do almost anything else than show up for a colonoscopy.  There have been many studies looking at ways to make patients get their screening colonoscopies when they are supposed to.  Patient outreach, primary care provider education, direct referral for colonoscopy without having to see a gastroenterologist, even paying patients to have a fecal occult blood test done (which often leads to colonoscopy) have all been tried as methods of increasing adherence to screening colonoscopy, all with limited success.

A recent study suggests that the simple act of giving the patient a date and time for their colonoscopy increases the chances that the test will actually get done.  This seems like common sense, but is actually a profound bit of wisdom.  Often, patients who come in seeking a colonoscopy don’t actually leave with an appointment for the test.  They don’t have their calendar handy, or have to coordinate a ride back home from the office, or just figure that they will call later to set the actual date.  Only sometimes this call back never happens, and time passes and the colonoscopy is forgotten.  Such is human nature.

By simply making an actual concrete appointment on the day of consultation, by committing to a specific  date and time, the chances of scope meeting colon increase, and therefore the chances of developing colon cancer decrease.  A win-win situation in my book.

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Bevan R, Rubin G, Sofianopoulou E, Patrick J, et al. Implementing a national flexible sigmoidoscopy screening program: Results of the English early pilot. Endoscopy 2015;47:225-31.

Kullgren JT, Dicks TN, Fu X, Richardson D, et al. Financial incentives for completion of fecal occult blood tests among veterans: A 2-stage, pragmatic, cluster, randomized, controlled trial. Ann Intern Med 2014 ;161:S35-43.