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  • Nov 27, 2018

Colorectal Cancer is a combination of rectal and colon cancer considered to be unpreventable and expected to account for 50,630 deaths in 2018. According to Cancer.net, Colorectal Cancer is the third most common cancer diagnosis among both women and men. The good news is that while Colorectal Cancer may be unpreventable, most of its associated risk factors are controllable and successful treatment is not uncommon – particularly in cases where proactive screenings lead to early intervention.

Upon a Colorectal Cancer diagnosis, the patient enters a staging process by which doctors determine how far the cancer has spread throughout the body. Altogether, there are five stages of Colorectal Cancer, ranging from stage 0 to stage 4. The American Cancer Society (ACS) charts these stages even further by assigning letters to each stage, i.e. Stage 1 (T1), which helps to further deduce the severity of the cancer within each stage.

In a perfect world, every diagnosis would be made in stage 0. However, according to cancer.net, the current early-stage diagnosis for Colorectal Cancer is only at 39% percent. When weighed against a 5-year 90% survival rate for localized (stage 0 or 1) Colorectal Cancer, it becomes clear that early-stage diagnosis is crucial for mitigating the overall health and cost impact of the disease.

Why are Early-Stage Diagnosis Rates Low?

Once Colorectal Cancer has spread to surrounding tissue and organs (stage 2) the 5-year survival rate drops by 19% - and can drop down to an overall 14% survival rate in later stages.

Early-stage diagnosis for Colorectal Cancer is low in part due to miseducation, poor screening implementation and lack of compliance. Improving early-stage screening or reducing risk factors of any disease is a complex task that requires a collection of health professionals coordinating care through ongoing multi-channel communication and patient management.

Furthermore, for some Colorectal Cancer patients, the symptoms will not appear until later stages, when the survival rate is significantly lowered. These considerations serve to illustrate the growing necessity for a comprehensively improved and implemented screening process. Without the proper tools and resources, however, the screening process will continue to produce suboptimal results.

Below is a list of people who are at a higher risk of developing colorectal cancer and common Colorectal Cancer risk factors:

Higher Risk Individuals:

Risk Factors

  • Obesity

  • Physical Inactivity

  • Poor Diet

  • Smoking / Heavy Alcohol Use

  • Aging

  • Genetics / Family History

  • Type 2 Diabetes

  • Ethnic Background

For comprehensive implementation of the Colorectal Cancer screening guidelines, healthcare providers should have the capacity to identify high-risk individuals who warrant a screening, the type of screening the individual needs and the screening frequency that is most appropriate for the individual. Providers can in-turn educate high-risk plan members with information that improves screening compliance and ultimately, early-stage diagnosis.

Coupling screening guidelines with analytical insight helps identify the right cohort groups (who needs screening, and when they need it), engage them through the right outreach program and manage them with the right resources.

Below are the two types of screening tests currently performed and the recommended screening ages.

Stool-Based Screening:

- Yearly FIT exam

- Yearly gFOBT exam

- MT-sDNA every 3 years

Visual Screening:

- Colonoscopy (every 10 years)

- CT colonography (every 5 years)

- FSIG (every 5 years)

Screening Ages:

- Ages 75 and below should get screened regularly

- Ages 76-85 should get screened circumstantially

- Ages 85+ no longer need to get screening

Change in Recommended Screening Age

Recently, the ACS updated the recommended screening age from 50 to 45 for people with an average risk. The driver behind this is to stay ahead of the disease by screening at a younger age in hopes that earlier screenings will lead to a higher percentage of early-stage diagnosis. Furthermore, determining the qualifiers helps define between an “average risk” vs a “high risk” member which then assists in the process of identifying, engaging and managing the next wave of at-risk individuals appropriately.

Currently, insurers are not required to cover the cost of Colorectal Cancer screenings before the age of 50. While the ACS can’t force insurers to follow and improve screening guidelines, prudent providers (and even employers) will put the resources in place to proactively improve early-stage diagnosis percentages.

The Importance of Identifying Those at Most Risk

Do you know what screening test and frequency best suits a 39-year-old type 2 diabetic male with a history of rectal cancer? If this person was on your health plan, how would you identify him?

These questions, and many like them, can be answered by integrating screening guidelines with health analytics’ ability to identify high-risk individuals via a variety of dynamic, customizable and longitudinal predictive and health analysis reports. These reports, delivered by healthcare analytics platforms such as Poindexter, help our clients to identify the top targets for this critical screening.


Contact us now to find out how our Poindexter analytics platform can deliver the visibility you’ve been missing to help you to implement screening guidelines successfully.