The Big Screen
Could a new test for colon cancer reduce fatalities? The discussion is politically charged, but a local health insurer sees the possibility of great benefits for patients.
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“We want to have 100 percent of our members screened,” says Dr. Paul Kaplan, chief medical officer of Blue Cross Blue Shield of Delaware. “Our colon cancer screening rates are higher than the national average. They’re still only around 60 percent, which means 40 percent of our eligible members are not getting screened for colon cancer. Our goal was to find another viable option.”
The pilot program, which began September 1, targeted eligible members in New Castle County and bordering counties. About 22,500 members and 500 primary care providers were informed of the program by mail. If it proves successful, BCBS of Delaware intends to use it as a model.
In a virtual colonoscopy, or CT colonography, a scanner creates images of the colon after it has been inflated with carbon dioxide, in 15 minutes or less. At the Colon Health Center of Delaware, patients can wait about 45 minutes while a CT-certified radiologist reads their images. Though the procedure does not require anesthesia, it does require the same 24-hour colon preparation that a traditional colonoscopy requires. Unlike traditional colonoscopy, however, polyps on the colon cannot be removed, if found.
So far, results at Colon Health Center of Delaware mirror the national trend, according to Baumel. Eighty percent of patients are cleared to go home or back to work. The 20 percent with polyps can proceed with a traditional colonoscopy for removal that day, thus avoiding the burdensome prospect of a second bowel preparation. From September through November, the Colon Health Center screened about 300 patients, according to Baumel. Of them, 40 went on to have colonoscopies that same day.
Baumel hopes to create similar operations with GI practices across the nation. “We have dozens of GI groups around the country who are interested,” he says. “We want to turn Colon Health Centers of America into the most compelling consumer brand for colon cancer screening. The reason why we are so intent on creating a consumer brand is because, right now, we are doing a highly inadequate job of getting Americans screened for colon cancer.”
This new technology, the Colon Health Center approach, and the BCBS of Delaware pilot program are being closely watched by many in the local medical community.
Dr. Nicholas Petrilli, head of the Helen F. Graham Cancer Center at Christiana Hospital, views the virtual colonoscopy as another useful screening option. “Colorectal cancer is a preventable cancer,” Petrilli says. “Any screening is better than no screening at all, but the gold standard is the colonoscopy.”
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