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Buffalo’s colon cancer-screening cooperation called ‘unprecedented’

More than a dozen organizations announced an ambitious effort Tuesday to increase colorectal cancer screening in Erie County as part of a national campaign.

The goal: to raise the nation’s colon cancer testing rate to 80 percent of adults 50 and older by 2018.

Nationally, more than 700 organizations so far have pledged to support the Roundtable goal.

Dr. Richard Wender, chief cancer control officer for the American Cancer Society, characterized the Buffalo collaboration as “unprecedented” because it involves every major competing hospital and health insurer in the area.

“This is the first city where every key health care stakeholder came together,” Wender said.

The 80 percent benchmark was set in 2014 at the start of the initiative organized by the National Colorectal Screening Roundtable, a group co-founded by the American Cancer Society and the federal Centers for Disease Control and Prevention.

Current screening rates are lower – about 65 percent nationally, 69 percent in New York State and 72 percent in Erie County.

Getting to 80 percent poses a challenge. It means screening an additional 23 million people in the United States, Wender said.

Colorectal cancer is the third-most commonly diagnosed cancer and the third-leading cause of cancer death in both men and women in the United States, according to the Society.

The U.S. Preventive Services Task Force, an independent group of medical experts, recommends colorectal cancer screening for most adults starting at age 50. These tests include a colonoscopy, in which a doctor uses a camera to look at the colon and rectum; a sigmoidoscopy, a similar procedure that examines part of the colon; and fecal occult blood testing that can find traces of blood in stool.

A colonoscopy, which can identify precancerous polyps, is the test most favored by many physicians. But many people don’t get the test because of its cost, potential risks and uncomfortable preparation. In contrast, a fecal occult blood test is inexpensive and can be done in the privacy of an individual’s home.

Wender said patients should consider the pros and cons of all the screening methods in consultation with doctors.

“Colonoscopy is highly effective, but we are not going to get to 80 percent by colonoscopy alone,” Wender said. “Patients and clinicians also should consider tests that are more affordable and easier.”

Colorectal cancer screening remains a debated issue. Just last month, for example, new Canadian guidelines advised that colonoscopy not be used for routine screening to detect colorectal cancer in patients with no symptoms or family history of the disease. The Canadian Task Force on Preventive Health Care recommends that low-risk patients aged 50 to 74 be screened using fecal occult blood tests or sigmoidoscopy.

A key reason for the lack of consensus is the lack of solid research evidence comparing colonoscopy to other screening methods, although those studies are under way.

The Roundtable offers dozens of steps hospitals, insurers and physicians can take to improve screening, such as waiving cost-sharing and tailoring messages to high-risk individuals in the community.

Roswell Park Cancer Institute plans a three-prong approach, said Mary Reid, director of cancer screening and survivorship.

This includes improving surveillance of its more than 3,000 workers, building on existing work to increase colorectal cancer screening among African-Americans in Buffalo, and a new initiative with Jericho Road Community Health Center.

“One of the first and best places we can start is with educating our own employees,” she said.