Colorectal cancer screenings…

… who gets them and who doesn’t is the subject of new research out from a combined institute at UNC-Chapel Hill and the RTP-based research company RTI.

Talked to RTI’s Debra Holden who lead the study, and she says there are folks who tend not to get screened. They’re:

-low income

-less educated

-have no insurance



-recent immigrants (less than 15 years in the US), and therefore unfamiliar with the US healthcare system

-have limited access to care, like in rural parts of NC

None of these is particularly surprising.

Now, there’s been a lot of chatter in the research about the cost-effectiveness of tests like colonoscopies and sigmoidoscopies. The argument is that they get used more because they generate money for doctors and screening centers – they’re reimbursed well.

But Holden says there are older technologies that are waaaay cheaper, such as the stool guaiac test (say GWEYE-ack). It’s a little card that the doctor gives you, you bring it home, collect a sample of your own poop and then give it back to the doctor.

Collecting your own poop usually elicits an, “Ewwwww!” but I’d ask if its worse than a tube stuck up your butt…

The guiac test, a.k.a. the occult blood test, works best if you do this three times – the test detects hidden (occult) blood. It costs less than a hundred dollars. Research shows it’s good for screening, and the national guidelines (CDC, American Cancer Society, et al) suggest this should be the first thing used, reserving sigmoidoscopies for once every 5 years and colonoscopies for once every 10 years.

However, Holden’s data show that rates of colonoscopy have increased over the past decade, while use of the other, cheaper-but-effective screening methods has stayed essentially flat.

Here’s how she put it:

“…there has been an awful lot of research done and studies published on different types of new tests, because our society tends to be enamored with new technologies, and so people always, if they talk about test, they want the newest, most innovative test that they can get even if it’s not necessarily proven that it would be the best option for them.

So there are a lot of research studies on that, and not so many on how you get people you to use the tests that we know work. So we were saying that there needed to be a lot more research done because there are some strategies out there that have been proven to work, to increase people’s screening rates, but not very much research done on that. So there needs to be more research done on that and less on these new high tech tests because we know we have some already that work.”

And that’s the straight poop…