With the medical community’s tools for screening, early detection and known prevention methods, colorectal cancer should have one of the lower rates for cancer deaths in the country. Unfortunately, it does not. In fact, data from the Centers for Disease Control (CDC) show colorectal cancer as the third leading cause of cancer deaths in the United States.
So, where exactly is the disconnect? Data collected by the CDC show that screening rates remain low, with about one in three adults not being tested as recommended by the American Cancer Society (ACA). This disparity could lead to approximately 20 million adults dying from an entirely preventable disease.
Creating awareness in the medical profession and the community at large is essential to changing the course of these statistics, as is increasing the screening at routine doctor’s appointments. In regards to the latter, medical assistants have a crucial part to play. Their proximity to both patients and the physicians who treat them make medical assistants uniquely suited to fill this essential role.
American Cancer Society Guidelines for Colorectal Cancer Screening
According to the ACA, screening should occur at the following intervals depending on risk factors:
- Patients at average risk should begin regular screening at age 45. If the patient remains in good health, with a life expectancy of over 10 years, they should continue screening until they are 75 years old.
- Patients with increased risk, including those with certain risk factors such as a history of inflammatory bowel disease or familial history of colorectal cancer should begin regular screening earlier. These patients will need to undergo more frequent screening and have specific tests performed.
Screening tests for colorectal cancer include stool-based and visual tests. Stool-based tests include the highly-sensitive fecal immunochemical test, the guaiac-based fecal occult blood test and the multi-targeted stool DNA test. Visual tests include a colonoscopy, CT colonography and flexible sigmoidoscopy. Stool-based testing can generally be taken at home, while visual tests involve going to a clinic or hospital.
Taking Action to Encourage Screening
In 2018, the National Colorectal Cancer Roundtable (NCCRT), in association with the ACA, conducted research into the disparities between patients who were routinely screened for colorectal cancer and those who were not. Among the study’s goals was to identify the barriers to screening, find methods to break through them, and apply what they learned to motivate patients to undergo testing. Some of the factors the study cited for missed screening included procrastination, the high cost of medical procedures, the unpleasantness of testing and patients mistakenly believing the risks did not apply to them. The study also found that one big motivator to undergoing screening was a strong recommendation from a trusted member of the medical community. The full results of the study are cited in NCCRT’s guidebook, “2019 Colorectal Cancer Screening Messaging Guidebook: Recommended Messaging to Reach the Unscreened.”
As an active NCCRT member, the American Association of Medical Assistants (AAMA) supports the goal of reaching sustained screening rates of 80 percent or higher. Their initiative includes providing training and education for medical assistants in the form of continuing education. The training aims to educate medical assistants on the importance of colorectal cancer screening, provide talking points and identify at-risk patients.
How Medical Assistants Can Improve Outcomes
Medical assistants are multi-skilled professionals, capable of performing both clinical and administrative functions in a medical practice. Their duties include taking vital signs and patient histories, performing in-office diagnostics and patient charting. In short, they are perfectly poised to identify and educate qualified patients on colorectal cancer screening.
As medical offices and doctors become busier and face increasing patient loads, the medical assistant’s role becomes more and more essential to patient outcomes. In the case of colorectal cancer screening, medical assistants can provide intervention by actively engaging patients in difficult conversations about the risks of remaining unscreened, connecting to why they need to stay healthy and helping them schedule screening tests. Medical assistants can also be used to audit patient charts prior to appointments and flag those who are due or overdue for colorectal cancer screening.
Medical practices need to take an active role in providing ongoing education for medical assistants as they fill this vital need. For instance, in-service training can be arranged through engagement with a local gastroenterologist practice or online training program. With educated assistants, physicians can have confidence that patients are receiving effective communication about the screening process.
Outcomes of Preventative Screening
It can’t be denied that screening saves lives. According to the ACA, it takes about 10 to 15 years for abnormal cells in the colon to become cancerous, allowing them to be easily removed before posing a danger to the patient. Screening also improves outcomes by finding colorectal cancer at an early stage when it is easier to treat. With such improved outcomes, the medical assistant’s role in encouraging screening cannot be underestimated.