Beyond the Cecum: Moving the Screening Needle Forward
Mark B. Pochapin, MD is the Sholtz-Leeds Professor of Gastroenterology, Director of the Division of Gastroenterology, and Vice Chair of Clinical Affairs in the Department of Medicine at NYU Langone Medical Center. Dr. Pochapin’s clinical focus is in advanced gastrointestinal endoscopy and the prevention, early detection, and treatment of gastrointestinal cancers, such as colorectal cancer. He is currently Secretary of the American College of Gastroenterology, a member of several medical and gastroenterology professional organizations, and the author of What Your Doctor May Not Tell You About Colorectal Cancer. Dr. Pochapin graduated from the University of Pennsylvania with a Bachelor of Science and Engineering degree, and received his medical degree from Cornell University Medical College. He completed his residency in internal medicine at NewYork-Presbyterian /Weill Cornell Medical Center and his fellowship in gastroenterology at the Albert Einstein College of Medicine.
As endoscopists, we have had the privilege of being on the front lines of the fight against colorectal cancer for over two decades—helping our patients not only to find and treat cancer early, but to prevent it altogether. I know it has been an honor for every one of us to be of service in this way. There is nothing more rewarding than being able to give a patient the “good news” that he or she had a suspicious polyp and it’s been successfully removed. And I know for all of us, it has been tremendously fulfilling to see those colorectal cancer mortality and incidence rates on the decline.
Now, more than ever, it’s time to double down and come together to do all we can to achieve our shared national goal of 80% by 2018—an 80% screening rate in men and women age 50 and older. Often, by the time we see a patient, he or she has already been referred by his or her primary care physician for a screening appointment. As endoscopists, we dedicate ourselves to providing a high-quality procedure, hitting quality benchmarks, and finding every potentially premalignant or malignant polyp we can. This is the most important role we play in the fight to end this disease. And yet, there are other things we can do to increase the screening rates and quality of our screening efforts.
One important step is to take advantage of the respected role we play in the community by serving as a clinical champion who can bring expertise to local efforts to increase colorectal cancer screening. We can make ourselves available as medical experts in getting the message out about screening to our communities. We can do this in a number of ways, including working through the communications or media department of our institutions, working with professional societies, partnering with advocacy groups, or serving as champions in local, state, and national coalitions. When we provide this type of public health message, it’s important to have prepared quick sound-bites with accurate information on the screening recommendations and benefits of colonoscopy. I believe it’s also important to make it clear that people have options and there are other colorectal cancer screening tests available. Finally, we know that the personal stories are what move people to action. I have found it can be very helpful to keep a HIPAA-compliant list of patients who have expressed interest in potentially serving as spokespersons for future media spots or other efforts to promote screening to the public.
The Roundtable’s new guide, What can gastroenterologists and endoscopists do to advance 80% by 2018? (1640 downloads) , is a wonderful resource that provides many more practical tips on how endoscopists can help achieve our goal of 80% by 2018. It is endorsed by the American College of Gastroenterology (ACG), American College of Surgeons (ACS), American Gastroenterological Association (AGA), and American Society for Gastrointestinal Endoscopy (ASGE).
I hope you will utilize this important resource—as well as those available from the ACG, ACS, AGA, ASGE, and GIQuIC (a quality benchmarking registry)—as a guide to achieving increased screening rates and optimal quality in endoscopy. Because, in the case of colorectal cancer screening, we know that more screening based on our recommended national guidelines means more lives saved. And that’s why making our national goal of an 80% screening rate by 2018 is so important. More screening, more quality, more prevention.
Together, we are saving lives. And together, we can save more.