Screening Initiative Cuts Down Colorectal Cancer Rates, Deaths by 50 Percent

Epoch Times

03-05-2025

Offering patients options to test for colorectal cancer may be a good strategy, according to the results of a study by Kaiser Permanente researchers presented at Digestive Disease Week. Investigators in this 20-year population-based study sent at-home kits for fecal immunochemical testing (FIT) along with colonoscopy reminders to patients overdue for colonoscopies.
'If you offer people more than one option for screening—such as colonoscopy or FIT—they're more likely to get screened than if you offer either option by itself,' Dr. Douglas Corley, researcher and gastroenterologist, said in a
Understanding FIT
FIT tests in particular are a great way to reach patients who live in rural areas, as well as young adults, who are experiencing more incidents of colorectal cancer even as the overall incidence declines, Corley said in an American Medical Association (AMA)
'So there are a lot of positives about it. And that's one of the reasons why the U.S. Preventive Services Task Force kind of equally recommends colonoscopy and FIT for benefit in terms of decreasing the risk of death from colorectal cancer,' he said in the AMA interview.
FIT tests are a noninvasive way to determine whether someone has blood in their stool. People with positive tests would then follow up with a colonoscopy. Some providers may also order Cologuard testing, which looks for DNA of cells shed in the stool, for abnormalities typical of cancer.
Study Findings
Screening rates—via colonoscopy, sigmoidoscopy, or FIT—grew from 37.4 percent in 2000 to 79.8 percent in 2019 across all racial and ethnic groups, according to the researchers.
Giving patients more options in the type of colorectal cancer screening they receive—including a FIT test mailed to their home—reduced the number of those who got cancer by a third, reduced the deaths in half, and eliminated nearly all the racial differences in screenings, diagnoses, and death.
There was a spike in colorectal cancer diagnoses during the first three years of the study—due to early detection—with overall incidence dropping across the cohort by 30 percent.
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Colorectal cancer deaths decreased by about 50 percent, with the largest reductions seen in black patients who have historically had worse outcomes from colorectal cancer. Deaths among black patients declined from 52.2 per 100,000 to 23.5 per 100,000.
Corley said during an online media briefing that the changes were sustained through the duration of the study.
'It's really remarkable that some of these large differences by mortality in race and ethnicity that we saw two decades ago and which we see throughout the United States are now similar,' he said.
These results demonstrate that offering more options to everyone levels the playing field for preventive care, he added.
Study Strengths
The size and scope of the study indicate that similar findings could be expected if it were reproduced, Corley said. The study also had diverse participants who reflected the population at large, and it followed them for two decades.
'This model could be applied to other preventable conditions with effective interventions such as hypertension and kidney disease,' said Corley.
Offering people choices—including a test they could do without leaving their house— is one way to reach more people and simplify the screening process. He added that colonoscopies aren't always convenient, as they may need to take a day off of work, and drinking the bowel prep can cause uncomfortable bowel movements. Corley noted that not everyone wants the risks involved with colonoscopies, which include tears, bleeding, infection, and reaction to sedatives.
One weakness of the study was that it didn't look at root cause issues like diet and environment that could be contributing to cause or death, he said, adding that exactly how these factors contribute is still uncertain.
However, Corley noted that screenings help everyone regardless of root cause, and the study proved that screenings do give patients a better chance to prevent cancer—and survive if they do get it.
'I think that was one of the more remarkable things. When you take something that is the second largest cause of cancer deaths and in a short period of time you cut that in half.'