Would A Lottery Ticket Tempt You to Get Colon Cancer Screening?

What You Need to Know: Convincing patients to do an often dreaded colon cancer screening test could just take a little extra nudge – like a chance to win $50. Patients who were told they had a 1-in-10 chance of winning $50 were more likely to complete home stool blood tests that help screen for colon cancer, according to a new study.

“Our study is another example of how modest financial incentives may go a long way in improving health behaviors and health care quality,” says author Jeffrey Kullgren, M.D., M.S. M.P.H. “Integrating a small lottery incentive into usual care is a low cost tool with potential to promote patients’ use of a service proven to saves lives by catching cancer early.”

Background: Officially called a fetal occult blood test, the home kit requires patients to take a sample of their bowel movement and mail it to a lab. The test helps detect hidden, microscopic blood in stool that may be an early sign of abnormal growths (polyps) or cancer in the colon. It is the least expensive way to screen for colon cancer and is recommended annually for people over the age of 50, but only about one-third of patients who are prescribed the home kit actually complete it.

The Study: Researchers wanted to see what price might help reverse the trend, looking at whether flat dollar amounts of up to $20, a chance to win $50 or raffle for $500 could be an effective incentive. The $50 lottery approach had the greatest impact, increasing the test completion rate by 20 percent. The study was done at the Philadelphia (USA) Veterans Affairs Medical Center among 1,549 patients who were prescribed the blood stool test.

“Fecal occult blood tests are inexpensive and an effective way to find colon cancer early and save lives. It’s up to the patient, however, to do this test at home and unfortunately completion rates are low,” says Kullgren, who is also a member of U-M’s Institute for Healthcare Policy and Innovation.

My Take: Low cost incentives may help us to improve our ability to prevent chronic diseases. This approach is worthy of more exploration in a number of health areas. I’m Dr. Michael Hunter.

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad: Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: University of Michigan Health System. “Need to encourage patients to screen for colon cancer? Try a lottery.” ScienceDaily. ScienceDaily, 17 November 2014. <www.sciencedaily.com/releases/2014/11/141117174330.htm>.

What’s Your Risk of Colorectal Cancer?

Please click image to see a colonoscopy.

Investigators at Cleveland Clinic (USA) have developed a new tool called CRC-PRO that allows clinicians to quickly and accurately predict an individual’s risk of colorectal cancer.

How They Developed the CRC-PRO Tool: To develop the Colorectal Cancer Predicted Risk Online tool, Brain Wells, MD, PhD and colleagues analyzed over 180,000 patients from a longitudinal study conducted at the University of Hawaii. Patients were followed for up to 11.5 years to determine the factors associated with the development of colon or rectal cancer.

“Creating a risk calculator that includes multiple risk factors offers clinicians a means to more accurately predict risk than the simple age-based cut-offs currently used in clinical practice,” said Dr. Wells. “Clinicians could decide to screen high-risk patients earlier than age 50, while delaying or foregoing screening in low-risk individuals.”

My Take: The Multiethnic Cohort Study include a diverse population. Previously, most research in this area has been performed predominately among whites. Because cancer risk varies dramatically by race, this tool is especially helpful. I think that risk prediction tools such as this will allow us to customize screening for individuals, in addition to pushing higher risk individuals to improve lifestyle factors linked to colorectal and other cancers. I’m Dr. Michael Hunter. Talk to your doctor about this valuable tool, available at http://www.r-calc.com/ExistingFormulas.aspx?filter=CCQHS

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page.

Available now: Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Both can be found at the Apple Ibooks store. Coming Soon for iPad:  Understand Breast Cancer in 60 Minutes; Understand Colon Cancer in 60 Minute; Understand Colon Cancer in 60 Minutes; Understand Brain Glioma in 60 Minutes. Thank you.

Reference: http://medicalexpress.com/news/2014-01-online-colorectal-cancer.html

The Worst Time to Have a Colonoscopy (And Other Procedures)

colonoscopy cartoonYou have probably heard that July is not a great time to have elective surgery, as this is the month that all the new doctors have their first day in the USA. Actually, the data is mixed. Still, there are some times that are more dangerous than others:

  1. Public holidays: If you are admitted to the hospital on an emergency basis on a public holiday, you are nearly 1.5x more likely to be dead a week later!
  2. Late in the day: Colonoscopies are less likely to find polyps, as compared to earlier in the day. With each hour of the day that passes, the average gastroenterologist is 4.6% less likely to find a polyp. And a Duke study showed that the likelihood of anesthesia problems increases over the course of the day: 1% at 9 am, rising to 4.2% for those starting at 4 pm.

Conclusion: Early to bed, early to get the best colonoscopy and surgeries, and stay safely in your home, motionless, on public holidays.

Atlantic Monthly, June 19, 2013

The small print: The material presented herein is informational only, and is not designed to provide specific guidance for an individual. Please check with a valued health care provider with any questions or concerns. As for me, I am a Harvard- , Yale- and UPenn-educated radiation oncologist, and I practice in the Seattle, WA (USA) area. I feel genuinely privileged to be able to share with you. If you enjoyed today’s offering, please consider clicking the follow button at the bottom of this page. Thanks!

 Interested in cancer? Check out my e-books for IPad at the ibooks store. Available now: Understand Col