New information about colorectal cancer screening guidelines available as a resource to physicians

The AOA has created an educational article that compiles the latest colorectal cancer screening guidelines. The full article is available here as a resource for physicians. A summary of the article is below:

In 2022, it was estimated that nearly 2 million people in the United States would be diagnosed with cancer, and there would be over 600,000 cancer-related deaths. Although these numbers are alarming, progress in the fight against cancer has been made over the past several decades, which is largely attributed to reductions in smoking and advances in early detection and treatment for some of the most common cancers.

Colorectal cancer (CRC) is the fourth most common type of cancer. It is also the leading cause of cancer death. Recently, the number of patients that have been screened for colorectal cancer has increased rather significantly. This is due to the number of insured patients increasing, as well as the Patient Protection and Affordable Care Act requiring the vast majority of insurance plans to cover all preventative health services.

Due to the challenges of the COVID-19 pandemic, screening rates and cancer diagnoses have fluctuated over the past three years. Additionally, the physician workforce shortage in the United States is growing, and is projected to exceed 139,000 by 2030. Factors such as burnout contribute to this shortage.

Although CRC screening rates declined across all patient populations during the COVID-19 pandemic, it is important to recognize that significant health disparities existed prior to March 2020. Underserved communities were disproportionately impacted by not only the challenges that resulted from the pandemic, but have been long impacted by physician shortages. These communities are among those most likely to be impacted by future challenges to the health care system.

Prior to the beginning of the COVID-19 pandemic, CRC rates were worse among certain racial and ethnic groups. CRC occurrence and mortality are highest in non-Hispanic blacks, followed by American Indians and Alaska Natives. These numbers are lowest in the Asian/Pacific Islander population. From 2012 to 2016, the CRC occurrence rates in black patients was about 20% higher than that in non-Hispanic whites and 50% higher than in Asians/Pacific Islanders.

In order to improve the way that care is delivered to underserved communities, the health care workforce must be augmented in a number of ways. The expansion and diversification of the primary care workforce, the strengthening of interprofessional teams and ensuring that the payment for health care services is sustainable are among the suggested improvements.

Additionally, efforts to strengthen the physician workforce must also account for the growing debt that physicians have when they complete their training. Approximately 76% of medical school graduates have student loans, averaging $190,000.

Finally, further exploration of unique models of care that are demonstrated to be effective and can be replicated should be implemented, such as the FluFIT initiative.

Although CRC screening in accordance with evidence-based guidelines helps prevent cancer or catch it when it is most treatable, access to these screening tools is unequal and barriers exist for many Americans. While there is no single solution, greater access to and integration with a physician-led health care team will improve access to screening services and result in better health outcomes. For more detailed findings and information, please visit the Solutions for Improved Access to Colorectal Cancer Screening and Patient Outcomes webpage.

Related reading:

USPSTF updates colorectal cancer screening guidelines

New JOM research reveals disparities in colorectal cancer screenings