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Home Screening Test is Good Alternative, Study Shows","publishDate":1453769583,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>An annual screening test for colon cancer that can be done at home showed strong effectiveness over several years, and patients who were sent the kits in the mail were very likely to participate year after year, \u003ca href=\"http://annals.org/article.aspx?articleid=2484289\" target=\"_blank\">a large study\u003c/a> from Kaiser in both Northern and Southern California found.\u003c/p>\n\u003cp>Colorectal cancer is the third-leading cause of death from cancer in the United States, with about 50,000 deaths and 130,000 new cases annually. Current screening guidelines recommend either colonoscopy, where a flexible tube is threaded into the colon, or a stool sample test, which can be done at home and mailed to a lab.\u003c/p>\n\u003cp>The home test, fecal immunochemical test or \"FIT,\" is recommended to be done annually but no study had looked at its performance over many years. The test detects blood in the stool, a warning sign of cancer.\u003c/p>\n\u003cp>In 2007 Kaiser began sending FIT tests to all members who were supposed to be screened for colorectal cancer but had not been. In the first year of analysis, more than 300,000 people completed the test and mailed it back.\u003c/p>\n\u003cp>In subsequent years, 75 to 86 percent of people sent back their tests, said study author Douglas Corley, a Kaiser gastroenterologist. Kaiser completed four total rounds of the test (stretching over more than four years, depending on when the first mailing to members happened).\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>In the analysis, the test was associated with \"high sensitivity\" for colorectal cancer, picking 84.5 percent of cancers in the first year of the study and 73 to 78 percent in subsequent years. (It's common for the first round of a screening program to detect more cancers.)\u003c/p>\n\u003cp>\"This study provides additional support,\" said Corley, \"that FIT can be an important tool for getting people screened that is both sensitive for picking up cancer and that people can comply with.\"\u003c/p>\n\u003cp>The study was published in the Annals of Internal Medicine and funded by a program of the National Cancer Institute.\u003c/p>\n\u003cp>National advocacy groups generally recommend that a person at average risk begin colorectal cancer screening at age 50. While colonoscopy is commonly referred to as a gold standard, it is not infallible. Both the colonoscopy and FIT have benefits and drawbacks.\u003c/p>\n\u003cp>Colonoscopy is an invasive test done once every 10 years for screening purposes. Many people find it unpleasant. The day before the procedure, the patient must cleanse the bowel by drinking a gallon or more of special solution. On the flip side, cancer can be prevented through colonoscopy, because non-cancerous polyps can be identified and removed. It is thought that many colon cancers begin as these polyps.\u003c/p>\n\u003cp>Because FIT is a non-invasive test, patients who choose this option forgo removal of non-cancerous polyps. Colon cancer is generally very slow-growing. While a single colonoscopy is more sensitive than a single FIT test, if a cancer is missed in the first year of FIT screening, it is likely to be picked up the next year. In addition, some colon cancers are very rapid-growing. It's possible that someone with a clean colonoscopy may develop a rapid-growing cancer in the 10 years before the next screening test. An annual FIT test would likely catch it.\u003c/p>\n\u003cp>If you opt for screening through the annual FIT, and you have a positive result, you'll need follow-up care, which is likely to include a colonoscopy.\u003c/p>\n\u003cp>But the big question is: How do the two tests compare in outcomes?\u003c/p>\n\u003cp>\"The studies that have looked at how well (FIT) does compared to colonoscopy,\" said Corley, \"suggest that they're fairly similar in preventing deaths from colon cancer.\"\u003c/p>\n\u003cp>While many people have heard of a colonoscopy, fewer patients and doctors are aware of FIT, said Robert Smith, vice president of cancer screening for the American Cancer Society, who was not affiliated with the study.\u003c/p>\n\u003cp>A \"significant fraction\" of people avoid colonoscopy, he said, but \"when you give people options to screen, when you offer them a stool test or colonoscopy, a sizable fraction will choose stool test and complete it,\" he said.\u003c/p>\n\u003cp>This study demonstrates that an organized home-screening program was successful in screening many people who might otherwise not have come in for a colonoscopy.\u003c/p>\n\u003cp>\"They're both very good tests,\" said Smith. Each has strength and limitations, but the stool testing should not be regarded as a second-class test as opposed to colonoscopy.\u003c/p>\n\u003cp>Kaiser's overall colon cancer screening rate is above 80 percent, Corley said, well above the national average of about 60 percent. \"That's because we offer a variety of different tests so that people can complete the ones that are acceptable and work for them.\"\u003c/p>\n\u003cp>If the rest of the country reached an 80 percent screening rate for colorectal cancer, 200,000 deaths and 280,000 new colorectal cancer cases would be avoided by 2030, \u003ca href=\"http://Public%20Health%20Impact%20of%20Achieving%2080%%20Colorectal%20Cancer%20Screening%20Rates%20in%20the%20United%20States%20by%202018\" target=\"_blank\">a previous study found. \u003c/a>A national effort is underway to\u003ca href=\"http://nccrt.org/tools/80-percent-by-2018/\" target=\"_blank\"> increase screening rates\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The takeaway is, if you are 50 years of age and older, you need to be screened for colon cancer,\" Smith said. \"If you are put off by colonoscopy, then (FIT) might be the right test for you.\"\u003c/p>\n\n","blocks":[],"excerpt":"A 'significant fraction' of the population doesn't want to have a colonoscopy. An annual test done at home is nearly as effective. ","status":"publish","parent":0,"modified":1464909318,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":866},"headData":{"title":"Put Off by Colonoscopy? Home Screening Test is Good Alternative, Study Shows | KQED","description":"A 'significant fraction' of the population doesn't want to have a colonoscopy. An annual test done at home is nearly as effective. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Put Off by Colonoscopy? Home Screening Test is Good Alternative, Study Shows","datePublished":"2016-01-26T00:53:03.000Z","dateModified":"2016-06-02T23:15:18.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"142607 http://ww2.kqed.org/stateofhealth/?p=142607","disqusUrl":"https://ww2.kqed.org/stateofhealth/2016/01/25/put-off-by-colonoscopy-home-screening-test-is-good-alternative-study-shows/","disqusTitle":"Put Off by Colonoscopy? Home Screening Test is Good Alternative, Study Shows","path":"/stateofhealth/142607/put-off-by-colonoscopy-home-screening-test-is-good-alternative-study-shows","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>An annual screening test for colon cancer that can be done at home showed strong effectiveness over several years, and patients who were sent the kits in the mail were very likely to participate year after year, \u003ca href=\"http://annals.org/article.aspx?articleid=2484289\" target=\"_blank\">a large study\u003c/a> from Kaiser in both Northern and Southern California found.\u003c/p>\n\u003cp>Colorectal cancer is the third-leading cause of death from cancer in the United States, with about 50,000 deaths and 130,000 new cases annually. Current screening guidelines recommend either colonoscopy, where a flexible tube is threaded into the colon, or a stool sample test, which can be done at home and mailed to a lab.\u003c/p>\n\u003cp>The home test, fecal immunochemical test or \"FIT,\" is recommended to be done annually but no study had looked at its performance over many years. The test detects blood in the stool, a warning sign of cancer.\u003c/p>\n\u003cp>In 2007 Kaiser began sending FIT tests to all members who were supposed to be screened for colorectal cancer but had not been. In the first year of analysis, more than 300,000 people completed the test and mailed it back.\u003c/p>\n\u003cp>In subsequent years, 75 to 86 percent of people sent back their tests, said study author Douglas Corley, a Kaiser gastroenterologist. Kaiser completed four total rounds of the test (stretching over more than four years, depending on when the first mailing to members happened).\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>In the analysis, the test was associated with \"high sensitivity\" for colorectal cancer, picking 84.5 percent of cancers in the first year of the study and 73 to 78 percent in subsequent years. (It's common for the first round of a screening program to detect more cancers.)\u003c/p>\n\u003cp>\"This study provides additional support,\" said Corley, \"that FIT can be an important tool for getting people screened that is both sensitive for picking up cancer and that people can comply with.\"\u003c/p>\n\u003cp>The study was published in the Annals of Internal Medicine and funded by a program of the National Cancer Institute.\u003c/p>\n\u003cp>National advocacy groups generally recommend that a person at average risk begin colorectal cancer screening at age 50. While colonoscopy is commonly referred to as a gold standard, it is not infallible. Both the colonoscopy and FIT have benefits and drawbacks.\u003c/p>\n\u003cp>Colonoscopy is an invasive test done once every 10 years for screening purposes. Many people find it unpleasant. The day before the procedure, the patient must cleanse the bowel by drinking a gallon or more of special solution. On the flip side, cancer can be prevented through colonoscopy, because non-cancerous polyps can be identified and removed. It is thought that many colon cancers begin as these polyps.\u003c/p>\n\u003cp>Because FIT is a non-invasive test, patients who choose this option forgo removal of non-cancerous polyps. Colon cancer is generally very slow-growing. While a single colonoscopy is more sensitive than a single FIT test, if a cancer is missed in the first year of FIT screening, it is likely to be picked up the next year. In addition, some colon cancers are very rapid-growing. It's possible that someone with a clean colonoscopy may develop a rapid-growing cancer in the 10 years before the next screening test. An annual FIT test would likely catch it.\u003c/p>\n\u003cp>If you opt for screening through the annual FIT, and you have a positive result, you'll need follow-up care, which is likely to include a colonoscopy.\u003c/p>\n\u003cp>But the big question is: How do the two tests compare in outcomes?\u003c/p>\n\u003cp>\"The studies that have looked at how well (FIT) does compared to colonoscopy,\" said Corley, \"suggest that they're fairly similar in preventing deaths from colon cancer.\"\u003c/p>\n\u003cp>While many people have heard of a colonoscopy, fewer patients and doctors are aware of FIT, said Robert Smith, vice president of cancer screening for the American Cancer Society, who was not affiliated with the study.\u003c/p>\n\u003cp>A \"significant fraction\" of people avoid colonoscopy, he said, but \"when you give people options to screen, when you offer them a stool test or colonoscopy, a sizable fraction will choose stool test and complete it,\" he said.\u003c/p>\n\u003cp>This study demonstrates that an organized home-screening program was successful in screening many people who might otherwise not have come in for a colonoscopy.\u003c/p>\n\u003cp>\"They're both very good tests,\" said Smith. Each has strength and limitations, but the stool testing should not be regarded as a second-class test as opposed to colonoscopy.\u003c/p>\n\u003cp>Kaiser's overall colon cancer screening rate is above 80 percent, Corley said, well above the national average of about 60 percent. \"That's because we offer a variety of different tests so that people can complete the ones that are acceptable and work for them.\"\u003c/p>\n\u003cp>If the rest of the country reached an 80 percent screening rate for colorectal cancer, 200,000 deaths and 280,000 new colorectal cancer cases would be avoided by 2030, \u003ca href=\"http://Public%20Health%20Impact%20of%20Achieving%2080%%20Colorectal%20Cancer%20Screening%20Rates%20in%20the%20United%20States%20by%202018\" target=\"_blank\">a previous study found. \u003c/a>A national effort is underway to\u003ca href=\"http://nccrt.org/tools/80-percent-by-2018/\" target=\"_blank\"> increase screening rates\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"The takeaway is, if you are 50 years of age and older, you need to be screened for colon cancer,\" Smith said. \"If you are put off by colonoscopy, then (FIT) might be the right test for you.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/142607/put-off-by-colonoscopy-home-screening-test-is-good-alternative-study-shows","authors":["240"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_193"],"featImg":"stateofhealth_142671","label":"stateofhealth"},"stateofhealth_86029":{"type":"posts","id":"stateofhealth_86029","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"86029","score":null,"sort":[1443627013000]},"guestAuthors":[],"slug":"african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","title":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","publishDate":1443627013,"format":"standard","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>Every year, 140,000 Americans are diagnosed with colon cancer, and more than 50,000 die from it. It's the third leading cause of cancer-related deaths. But among those tens of thousands who are suffering, African-Americans are especially vulnerable.\u003c/p>\n\u003cp>“African-Americans are more likely to get colon cancer, they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer,\" says Dr. Fola May, a gastroenterologist at UCLA. \"They’re more likely to die from colon cancer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\n“It’s a message that we need to get out, especially to the African-American community, that by going and having a colonoscopy, you lessen the chances of being diagnosed with this.\"\u003cbr>\n\u003ccite>Erin Stennis, widow of colon cancer patient\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>May is co-author of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25737445\" target=\"_blank\">recent study\u003c/a> that looked at the records of Californians between 40 and 80 years old who have a parent, sibling, or child that’s had colon cancer. That population is at higher risk of developing colon cancer themselves. But of that group, only three out of five had been screened for colon cancer themselves.\u003c/p>\n\u003cp>Dr. Brennan Spiegel, senior author of the study and director of health services at Cedars Sinai in Los Angeles, said this finding revealed \"a big problem.\" The findings grew more sobering from there.\u003c/p>\n\u003cp>\"(W)hen we drilled down into that group and looked at racial and ethnic disparities, we found that African-Americans were 71 percent less likely to get screened than white Californians,\" he said. \"So, this is an even bigger indictment.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Colon cancer screening is especially beneficial, because benign lesions can be found and removed, preventing cancer from having a chance to develop.\u003c/p>\n\u003cp>You might think that close relatives of colon cancer patients would want to be screened. But take the case of the family of Cordell Harper, a 67-year-old African-American man. Fourteen years ago he was diagnosed with colon cancer. He underwent surgery and chemotherapy.\u003c/p>\n\u003cp>Harper has three brothers. They all refuse to get colonoscopies.\u003c/p>\n\u003cp>“So, if having a brother get colon cancer doesn’t make you want to get a colonoscopy, what will?” he asks, with a laugh. \"Having issues, you know, and it may be too late then.”\u003c/p>\n\u003cp>Harper’s brothers are all over 50. That’s the age many\u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening\" target=\"_blank\"> national organizations\u003c/a> recommend people begin colon cancer screening. But those with a family history \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">should start sooner\u003c/a>. Part of the reason Harper’s brothers won’t get screened has to do with the stigma of having a colonoscopy, which involves threading a flexible tube, called a colonoscope, through the rectum and into the colon. Dr. Fola May says that’s a common concern.\u003c/p>\n\u003cp>“Men in our \u003ca href=\"http://www.researchgate.net/publication/276209726_Addressing_Low_Colorectal_Cancer_Screening_in_African_Americans_Using_Focus_Groups_to_Inform_the_Development_of_Effective_Interventions\" target=\"_blank\">focus group study \u003c/a>and men in other studies have said, ‘I do not want any sort of procedure where I have to have any sort of instrument that’s placed into my behind,' \" May said. \"That was a persistent theme throughout our ... studies.”\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/226272254\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>That was the case with Michael Stennis, who died of colon cancer in 2003. I met his wife, Erin Stennis, at a “Relay for Life” cancer event in Los Angeles this summer. After he found blood in his stool, a gastroenterologist told him to get a colonoscopy.\u003c/p>\n\u003cp>“When he found out what a colonoscopy was, he said no one was going to do that to him,\" Erin Stennis told me. \"So he literally sucked up the pain for about six years, and it got to the point where I found him one day hunched over in a closet in our home.”\u003c/p>\n\u003cp>Her husband was soon diagnosed with stage four colon cancer. He lived just two more years. During that time, the couple talked to everyone they could, going to churches and other groups, to try to raise awareness of colon cancer among African Americans.\u003c/p>\n\u003cp>“I think it’s a message that we need to get out, especially to the African-American community,\" Erin Stennis said, \"that by going and having a colonoscopy, you lessen the chances of being diagnosed with this. It’s getting over the stigma attached to colonoscopy and what the procedure entails.\"\u003c/p>\n\u003cp>But the low screening rates are due to more than stigma. In another \u003ca href=\"http://www.gastrojournal.org/article/S0016-5085(15)32000-X/abstract\" target=\"_blank\">study\u003c/a>, Spiegel and his colleagues, found that part of the responsibility may rest with doctors.\u003c/p>\n\u003cp>“We found that African-Americans were more likely to say that their doctor never recommended a colonoscopy or any kind of colon cancer screening than any other racial and ethnic groups,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel says that’s a big failure at the provider level. A nudge from the doctor could make a big difference.\u003c/p>\n\u003cp>“We found that when doctors do recommend screening, it increases the chances of getting screened by nearly twofold,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel’s team is planning a follow-up study to see if the Affordable Care Act, which fully covers preventive tests like colonoscopies, will make any dent in the racial disparity of colon cancer outcomes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Avishay Artsy reported this story as a 2015 California Health Journalism Fellow at the USC Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"They are more likely to be diagnosed with advanced disease and are more likely to die of colon cancer.","status":"publish","parent":0,"modified":1443636107,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":922},"headData":{"title":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened | KQED","description":"They are more likely to be diagnosed with advanced disease and are more likely to die of colon cancer.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","datePublished":"2015-09-30T15:30:13.000Z","dateModified":"2015-09-30T18:01:47.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"86029 http://ww2.kqed.org/stateofhealth/?p=86029","disqusUrl":"https://ww2.kqed.org/stateofhealth/2015/09/30/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened/","disqusTitle":"African-Americans Face Higher Colon Cancer Risk, Less Likely to be Screened","nprByline":"Avishay Artsy","path":"/stateofhealth/86029/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Every year, 140,000 Americans are diagnosed with colon cancer, and more than 50,000 die from it. It's the third leading cause of cancer-related deaths. But among those tens of thousands who are suffering, African-Americans are especially vulnerable.\u003c/p>\n\u003cp>“African-Americans are more likely to get colon cancer, they’re more likely to have an advanced stage of disease when they’re diagnosed with colon cancer,\" says Dr. Fola May, a gastroenterologist at UCLA. \"They’re more likely to die from colon cancer.”\u003c/p>\n\u003caside class=\"pullquote alignright\">\n“It’s a message that we need to get out, especially to the African-American community, that by going and having a colonoscopy, you lessen the chances of being diagnosed with this.\"\u003cbr>\n\u003ccite>Erin Stennis, widow of colon cancer patient\u003c/cite>\u003cbr>\n\u003c/aside>\n\u003cp>May is co-author of a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/25737445\" target=\"_blank\">recent study\u003c/a> that looked at the records of Californians between 40 and 80 years old who have a parent, sibling, or child that’s had colon cancer. That population is at higher risk of developing colon cancer themselves. But of that group, only three out of five had been screened for colon cancer themselves.\u003c/p>\n\u003cp>Dr. Brennan Spiegel, senior author of the study and director of health services at Cedars Sinai in Los Angeles, said this finding revealed \"a big problem.\" The findings grew more sobering from there.\u003c/p>\n\u003cp>\"(W)hen we drilled down into that group and looked at racial and ethnic disparities, we found that African-Americans were 71 percent less likely to get screened than white Californians,\" he said. \"So, this is an even bigger indictment.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Colon cancer screening is especially beneficial, because benign lesions can be found and removed, preventing cancer from having a chance to develop.\u003c/p>\n\u003cp>You might think that close relatives of colon cancer patients would want to be screened. But take the case of the family of Cordell Harper, a 67-year-old African-American man. Fourteen years ago he was diagnosed with colon cancer. He underwent surgery and chemotherapy.\u003c/p>\n\u003cp>Harper has three brothers. They all refuse to get colonoscopies.\u003c/p>\n\u003cp>“So, if having a brother get colon cancer doesn’t make you want to get a colonoscopy, what will?” he asks, with a laugh. \"Having issues, you know, and it may be too late then.”\u003c/p>\n\u003cp>Harper’s brothers are all over 50. That’s the age many\u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/colorectal-cancer-screening\" target=\"_blank\"> national organizations\u003c/a> recommend people begin colon cancer screening. But those with a family history \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">should start sooner\u003c/a>. Part of the reason Harper’s brothers won’t get screened has to do with the stigma of having a colonoscopy, which involves threading a flexible tube, called a colonoscope, through the rectum and into the colon. Dr. Fola May says that’s a common concern.\u003c/p>\n\u003cp>“Men in our \u003ca href=\"http://www.researchgate.net/publication/276209726_Addressing_Low_Colorectal_Cancer_Screening_in_African_Americans_Using_Focus_Groups_to_Inform_the_Development_of_Effective_Interventions\" target=\"_blank\">focus group study \u003c/a>and men in other studies have said, ‘I do not want any sort of procedure where I have to have any sort of instrument that’s placed into my behind,' \" May said. \"That was a persistent theme throughout our ... studies.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/226272254&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/226272254'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That was the case with Michael Stennis, who died of colon cancer in 2003. I met his wife, Erin Stennis, at a “Relay for Life” cancer event in Los Angeles this summer. After he found blood in his stool, a gastroenterologist told him to get a colonoscopy.\u003c/p>\n\u003cp>“When he found out what a colonoscopy was, he said no one was going to do that to him,\" Erin Stennis told me. \"So he literally sucked up the pain for about six years, and it got to the point where I found him one day hunched over in a closet in our home.”\u003c/p>\n\u003cp>Her husband was soon diagnosed with stage four colon cancer. He lived just two more years. During that time, the couple talked to everyone they could, going to churches and other groups, to try to raise awareness of colon cancer among African Americans.\u003c/p>\n\u003cp>“I think it’s a message that we need to get out, especially to the African-American community,\" Erin Stennis said, \"that by going and having a colonoscopy, you lessen the chances of being diagnosed with this. It’s getting over the stigma attached to colonoscopy and what the procedure entails.\"\u003c/p>\n\u003cp>But the low screening rates are due to more than stigma. In another \u003ca href=\"http://www.gastrojournal.org/article/S0016-5085(15)32000-X/abstract\" target=\"_blank\">study\u003c/a>, Spiegel and his colleagues, found that part of the responsibility may rest with doctors.\u003c/p>\n\u003cp>“We found that African-Americans were more likely to say that their doctor never recommended a colonoscopy or any kind of colon cancer screening than any other racial and ethnic groups,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel says that’s a big failure at the provider level. A nudge from the doctor could make a big difference.\u003c/p>\n\u003cp>“We found that when doctors do recommend screening, it increases the chances of getting screened by nearly twofold,” Dr. Spiegel said.\u003c/p>\n\u003cp>Dr. Spiegel’s team is planning a follow-up study to see if the Affordable Care Act, which fully covers preventive tests like colonoscopies, will make any dent in the racial disparity of colon cancer outcomes.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Avishay Artsy reported this story as a 2015 California Health Journalism Fellow at the USC Annenberg School of Journalism.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/86029/african-americans-face-higher-colon-cancer-risk-less-likely-to-be-screened","authors":["byline_stateofhealth_86029"],"categories":["stateofhealth_11","stateofhealth_13"],"tags":["stateofhealth_193","stateofhealth_249","stateofhealth_2519"],"featImg":"stateofhealth_86077","label":"stateofhealth"},"stateofhealth_18529":{"type":"posts","id":"stateofhealth_18529","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"18529","score":null,"sort":[1396647860000]},"guestAuthors":[],"slug":"your-doctors-skill-at-colonoscopy-may-reduce-your-later-colon-cancer-risk","title":"Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk","publishDate":1396647860,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-e1396647760530.jpg\">\u003cimg class=\"size-large wp-image-18548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-640x437.jpg\" alt=\"136237601\" width=\"640\" height=\"437\">\u003c/a>\u003cbr>\nIf you're going to go to the trouble of having a colonoscopy, you'd probably prefer that you get as much as you can out of the screening test. A new study this week shows that a doctor's rate of finding and removing adenomas -- these are pre-cancerous growths -- is linked to the patient's lower risk of developing colon cancer later.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For every 1 percent increase in adenoma detection there was a 3 percent decrease a person's colon cancer risk. \u003c/aside>\n\u003cp>Colonoscopy is one of the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">recommended screening tests\u003c/a> for colon cancer. Yet doctors have differing rates at how often they find these adenomas. This is the first study in the U.S. to look at the association between finding adenomas and later cancer risk, as part of a national review funded by the National Cancer Institute. It was published in the\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1309086\" target=\"_blank\"> New England Journal of Medicine.\u003c/a>\u003c/p>\n\u003cp>In the study, researchers at Kaiser Permanente Northern California reviewed more than 300,000 colonoscopies performed by 136 gastroenterologists between 1998 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>The doctors' detection rates for adenomas ranged from 7.4 percent to 52.5 percent. The researchers found that for every 1 percent increase in detection rate there was a 3 percent decrease in colon cancer risk over the next decade.\u003c/p>\n\u003cp>Dr. Douglas Corley is research scientist with Kaiser's Department of Research and lead author of the study. \"The (doctors) who were at the higher end of the detection, their patients were actually less likely in the future to be diagnosed with a colon cancer, an advanced colon cancer and to die of colon cancer,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Medicare is in the process of setting standards for doctors' groups to report their detection of adenomas as a quality measure but \"patients certainly ask their physicians if their groups measure adenoma detection rates\" now, Corley said.\u003c/p>\n\u003cp>HealthDay spoke to a gastroenterologist not involved in the study who backed up Corley's recommendation. \u003ca href=\"http://consumer.healthday.com/cancer-information-5/colon-cancer-news-96/doctor-s-skill-at-colonoscopy-affects-patient-s-colon-cancer-risk-study-686446.html\" target=\"_blank\">From HealthDay\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Many (doctors) make quality measures available to their patients,\" said Dr. Lawrence Kim, who serves as the community private practice councilor for the American Gastroenterological Association (AGA).\u003c/p>\n\u003cp>That information may be in the written materials your doctor gives you, or even on the practice's website, Kim said.\u003c/p>\u003c/blockquote>\n\u003cp>A \"minimum threshold\" for finding adenomas is at least 15 percent for women and 25 percent for men, Corley noted. Adenomas are more common in men. Most of the doctors in the study were above 20 percent overall. Kaiser is working to develop interventions to improve adenoma detection rates among all doctors, he said. Those interventions may ultimately be applied to physicians beyond Kaiser.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eyYxSV4FoBl5SCktFpYEH8WMHNf2BlSD\"]\u003c/p>\n\n","blocks":[],"excerpt":"Major study finds that the more adenomas the doctor removes, the lower a patient's later risk of cancer.","status":"publish","parent":0,"modified":1396992379,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":444},"headData":{"title":"Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk | KQED","description":"Major study finds that the more adenomas the doctor removes, the lower a patient's later risk of cancer.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk","datePublished":"2014-04-04T21:44:20.000Z","dateModified":"2014-04-08T21:26:19.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"18529 http://blogs.kqed.org/stateofhealth/?p=18529","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/04/04/your-doctors-skill-at-colonoscopy-may-reduce-your-later-colon-cancer-risk/","disqusTitle":"Your Doctor's Skill at Colonoscopy May Reduce Your Later Colon Cancer Risk","path":"/stateofhealth/18529/your-doctors-skill-at-colonoscopy-may-reduce-your-later-colon-cancer-risk","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-e1396647760530.jpg\">\u003cimg class=\"size-large wp-image-18548\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2014/04/136237601-640x437.jpg\" alt=\"136237601\" width=\"640\" height=\"437\">\u003c/a>\u003cbr>\nIf you're going to go to the trouble of having a colonoscopy, you'd probably prefer that you get as much as you can out of the screening test. A new study this week shows that a doctor's rate of finding and removing adenomas -- these are pre-cancerous growths -- is linked to the patient's lower risk of developing colon cancer later.\u003c/p>\n\u003caside class=\"pullquote alignleft\">For every 1 percent increase in adenoma detection there was a 3 percent decrease a person's colon cancer risk. \u003c/aside>\n\u003cp>Colonoscopy is one of the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-acs-recommendations\" target=\"_blank\">recommended screening tests\u003c/a> for colon cancer. Yet doctors have differing rates at how often they find these adenomas. This is the first study in the U.S. to look at the association between finding adenomas and later cancer risk, as part of a national review funded by the National Cancer Institute. It was published in the\u003ca href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1309086\" target=\"_blank\"> New England Journal of Medicine.\u003c/a>\u003c/p>\n\u003cp>In the study, researchers at Kaiser Permanente Northern California reviewed more than 300,000 colonoscopies performed by 136 gastroenterologists between 1998 and 2010.\u003c!--more-->\u003c/p>\n\u003cp>The doctors' detection rates for adenomas ranged from 7.4 percent to 52.5 percent. The researchers found that for every 1 percent increase in detection rate there was a 3 percent decrease in colon cancer risk over the next decade.\u003c/p>\n\u003cp>Dr. Douglas Corley is research scientist with Kaiser's Department of Research and lead author of the study. \"The (doctors) who were at the higher end of the detection, their patients were actually less likely in the future to be diagnosed with a colon cancer, an advanced colon cancer and to die of colon cancer,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Medicare is in the process of setting standards for doctors' groups to report their detection of adenomas as a quality measure but \"patients certainly ask their physicians if their groups measure adenoma detection rates\" now, Corley said.\u003c/p>\n\u003cp>HealthDay spoke to a gastroenterologist not involved in the study who backed up Corley's recommendation. \u003ca href=\"http://consumer.healthday.com/cancer-information-5/colon-cancer-news-96/doctor-s-skill-at-colonoscopy-affects-patient-s-colon-cancer-risk-study-686446.html\" target=\"_blank\">From HealthDay\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"Many (doctors) make quality measures available to their patients,\" said Dr. Lawrence Kim, who serves as the community private practice councilor for the American Gastroenterological Association (AGA).\u003c/p>\n\u003cp>That information may be in the written materials your doctor gives you, or even on the practice's website, Kim said.\u003c/p>\u003c/blockquote>\n\u003cp>A \"minimum threshold\" for finding adenomas is at least 15 percent for women and 25 percent for men, Corley noted. Adenomas are more common in men. Most of the doctors in the study were above 20 percent overall. Kaiser is working to develop interventions to improve adenoma detection rates among all doctors, he said. Those interventions may ultimately be applied to physicians beyond Kaiser.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[contextly_auto_sidebar id=\"eyYxSV4FoBl5SCktFpYEH8WMHNf2BlSD\"]\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/18529/your-doctors-skill-at-colonoscopy-may-reduce-your-later-colon-cancer-risk","authors":["240"],"categories":["stateofhealth_13"],"tags":["stateofhealth_193","stateofhealth_461"],"featImg":"stateofhealth_18548","label":"stateofhealth"},"stateofhealth_17439":{"type":"posts","id":"stateofhealth_17439","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"17439","score":null,"sort":[1391477679000]},"guestAuthors":[],"slug":"at-home-test-good-alternative-to-colonoscopy-study-finds","title":"At-Home Test Good Alternative to Colonoscopy, Study Confirms","publishDate":1391477679,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>If you're like most of my colleagues in the newsroom, you read that headline and thought, \"GREAT! What is the alternative test?!\"\u003c/p>\n\u003cp>Here's the quick background: Colorectal cancer is the third most common cancer killer in the U.S. A colonoscopy is an excellent screening tool. But more than one-third of people who are supposed to get it (that's people ages 50-75) don't.\u003c/p>\n\u003cp>Why? I think you can guess.\u003c/p>\n\u003cp>A colonoscopy is an invasive screening test that can involve missing one to two days of work, an inconvenient preparation process and then a \"colonoscope is gently eased inside the colon and sends pictures to a TV screen,\" the American Cancer Society \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/examandtestdescriptions/faq-colonoscopy-and-sigmoidoscopy\" target=\"_blank\">says\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>But it turns out that there's a less invasive option. It's called FIT -- fecal immunochemical test -- and essentially, you are taking a stool sample at home, in the privacy of your own bathroom. There's no preparation and there are no dietary restrictions. FIT will detect hidden blood in the stool, a sign of colon cancer or large polyps that could become cancerous.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-screening-tests-used\" target=\"_blank\">American Cancer Society\u003c/a> explains how it works:\u003c/p>\n\u003cblockquote>\u003cp>… blood vessels at the surface of larger colorectal polyps or cancers are often fragile and easily damaged by the passage of feces. The damaged vessels usually release a small amount of blood into the feces, but only rarely is there enough bleeding for blood to be visible in the stool.\u003c/p>\u003c/blockquote>\n\u003cp>FIT is not new -- it's already a recommended screening test from both the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-screening-tests-used\" target=\"_blank\">American Cancer Society\u003c/a> and the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf08/colocancer/colors.htm\" target=\"_blank\">U.S. Preventive Services Task Force\u003c/a>, but few people know about it.\u003c/p>\n\u003cp>The doctors behind \u003ca href=\"http://annals.org/article.aspx?articleid=1819122\" target=\"_blank\">a study\u003c/a> published Monday -- from UCSF and Kaiser Permanente's Division of Research -- are hoping their research will change that. The researchers conducted what's called a meta-analysis, a review of existing studies, to reach their conclusion.\u003c/p>\n\u003cp>In their review, doctors found that FIT correctly identified 80 percent of people who have cancer, and FIT correctly identified more than 94 percent of people who did not have cancer.\u003c/p>\n\u003cp>Now, you might be thinking the inverse -- that 20 percent of people with cancer were missed. But FIT is a test that's meant to be done annually, and colon cancers generally are slow-growing. \"You will be tested (again) after a year goes by,\" said Dr. Jeffrey Lee, lead author of the study who works at both Kaiser Permanente's Division of Research and UCSF. \"During year two, the chances that the FIT test will detect it is much higher.\"\u003c/p>\n\u003cp>In addition, if non-cancerous polyps are removed, then patients may well be avoiding a later cancer diagnosis.\u003c/p>\n\u003cp>Dr. Theodore Levin, another of the study's authors, heads up colorectal screening for the Permanente Medical Group. Kaiser instituted a coordinated screening approach for its members several years ago, which includes mailing FITs to its members who are not up-to-date on screening. Kaiser's screening rate is going up and the incidence of colorectal cancer is going down.\u003c/p>\n\u003cp>\"FIT represents a really easy-to-use option for colon screening,\" Levin says. \"It's a much easier sell to get people to do the FIT test\" than undergo a colonoscopy. \"There's no way around it.\"\u003c/p>\n\u003cp>The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleid=1819122\" target=\"_blank\">Annals of Internal Medicine\u003c/a>.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"If you're like most of my colleagues in the newsroom, you read that headline and thought, \"GREAT! What is the alternative test?!\"\r\n\r\nHere's the quick background: colorectal cancer is the third most common cancer killer in the U.S. The colonoscopy is an excellent screening tool. But more than one-third of people who are supposed to get it (that's people ages 50-75) don't.\r\n\r\nWhy? I think you can guess.","status":"publish","parent":0,"modified":1391670646,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":558},"headData":{"title":"At-Home Test Good Alternative to Colonoscopy, Study Confirms | KQED","description":"If you're like most of my colleagues in the newsroom, you read that headline and thought, "GREAT! What is the alternative test?!"\r\n\r\nHere's the quick background: colorectal cancer is the third most common cancer killer in the U.S. The colonoscopy is an excellent screening tool. But more than one-third of people who are supposed to get it (that's people ages 50-75) don't.\r\n\r\nWhy? I think you can guess.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"At-Home Test Good Alternative to Colonoscopy, Study Confirms","datePublished":"2014-02-04T01:34:39.000Z","dateModified":"2014-02-06T07:10:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"17439 http://blogs.kqed.org/stateofhealth/?p=17439","disqusUrl":"https://ww2.kqed.org/stateofhealth/2014/02/03/at-home-test-good-alternative-to-colonoscopy-study-finds/","disqusTitle":"At-Home Test Good Alternative to Colonoscopy, Study Confirms","path":"/stateofhealth/17439/at-home-test-good-alternative-to-colonoscopy-study-finds","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you're like most of my colleagues in the newsroom, you read that headline and thought, \"GREAT! What is the alternative test?!\"\u003c/p>\n\u003cp>Here's the quick background: Colorectal cancer is the third most common cancer killer in the U.S. A colonoscopy is an excellent screening tool. But more than one-third of people who are supposed to get it (that's people ages 50-75) don't.\u003c/p>\n\u003cp>Why? I think you can guess.\u003c/p>\n\u003cp>A colonoscopy is an invasive screening test that can involve missing one to two days of work, an inconvenient preparation process and then a \"colonoscope is gently eased inside the colon and sends pictures to a TV screen,\" the American Cancer Society \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/examandtestdescriptions/faq-colonoscopy-and-sigmoidoscopy\" target=\"_blank\">says\u003c/a>.\u003c!--more-->\u003c/p>\n\u003cp>But it turns out that there's a less invasive option. It's called FIT -- fecal immunochemical test -- and essentially, you are taking a stool sample at home, in the privacy of your own bathroom. There's no preparation and there are no dietary restrictions. FIT will detect hidden blood in the stool, a sign of colon cancer or large polyps that could become cancerous.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-screening-tests-used\" target=\"_blank\">American Cancer Society\u003c/a> explains how it works:\u003c/p>\n\u003cblockquote>\u003cp>… blood vessels at the surface of larger colorectal polyps or cancers are often fragile and easily damaged by the passage of feces. The damaged vessels usually release a small amount of blood into the feces, but only rarely is there enough bleeding for blood to be visible in the stool.\u003c/p>\u003c/blockquote>\n\u003cp>FIT is not new -- it's already a recommended screening test from both the \u003ca href=\"http://www.cancer.org/cancer/colonandrectumcancer/moreinformation/colonandrectumcancerearlydetection/colorectal-cancer-early-detection-screening-tests-used\" target=\"_blank\">American Cancer Society\u003c/a> and the \u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf08/colocancer/colors.htm\" target=\"_blank\">U.S. Preventive Services Task Force\u003c/a>, but few people know about it.\u003c/p>\n\u003cp>The doctors behind \u003ca href=\"http://annals.org/article.aspx?articleid=1819122\" target=\"_blank\">a study\u003c/a> published Monday -- from UCSF and Kaiser Permanente's Division of Research -- are hoping their research will change that. The researchers conducted what's called a meta-analysis, a review of existing studies, to reach their conclusion.\u003c/p>\n\u003cp>In their review, doctors found that FIT correctly identified 80 percent of people who have cancer, and FIT correctly identified more than 94 percent of people who did not have cancer.\u003c/p>\n\u003cp>Now, you might be thinking the inverse -- that 20 percent of people with cancer were missed. But FIT is a test that's meant to be done annually, and colon cancers generally are slow-growing. \"You will be tested (again) after a year goes by,\" said Dr. Jeffrey Lee, lead author of the study who works at both Kaiser Permanente's Division of Research and UCSF. \"During year two, the chances that the FIT test will detect it is much higher.\"\u003c/p>\n\u003cp>In addition, if non-cancerous polyps are removed, then patients may well be avoiding a later cancer diagnosis.\u003c/p>\n\u003cp>Dr. Theodore Levin, another of the study's authors, heads up colorectal screening for the Permanente Medical Group. Kaiser instituted a coordinated screening approach for its members several years ago, which includes mailing FITs to its members who are not up-to-date on screening. Kaiser's screening rate is going up and the incidence of colorectal cancer is going down.\u003c/p>\n\u003cp>\"FIT represents a really easy-to-use option for colon screening,\" Levin says. \"It's a much easier sell to get people to do the FIT test\" than undergo a colonoscopy. \"There's no way around it.\"\u003c/p>\n\u003cp>The study was published in the \u003ca href=\"http://annals.org/article.aspx?articleid=1819122\" target=\"_blank\">Annals of Internal Medicine\u003c/a>.\u003c/p>\n\u003cp> \u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/17439/at-home-test-good-alternative-to-colonoscopy-study-finds","authors":["240"],"categories":["stateofhealth_166","stateofhealth_13"],"tags":["stateofhealth_193","stateofhealth_461"],"label":"stateofhealth"},"stateofhealth_13654":{"type":"posts","id":"stateofhealth_13654","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"13654","score":null,"sort":[1373933756000]},"guestAuthors":[],"slug":"headaches-heart-disease-stroke-can-aspirin-prevent-cancer-too","title":"Headaches, Heart Disease, Stroke; Can Aspirin Prevent Cancer, Too?","publishDate":1373933756,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_13656\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13656\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/aspirin_ThinkStock-620x586.jpg\" alt=\"(Photo: Getty Images)\" width=\"620\" height=\"586\">\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>We've known for years that the lowly over-the-counter aspirin not only relieves headaches, but it can also reduce your risk of heart attack and stroke. Now researchers have demonstrated aspirin can do even more: it may prevent cancer, specifically colon cancer in women.\u003c/p>\n\u003cp>There has been mounting \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22036019\" target=\"_blank\">evidence\u003c/a> that links aspirin use to lower rates of cancer, particularly gastrointestinal cancers like colon cancer. Yet, few studies have set out to directly ask whether aspirin actually reduces cases of cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Over the 18 year study, women who took aspirin reduced their risk of colon cancer by about 20 percent.\u003c/aside>\n\u003cp>Results from the \u003ca href=\"http://annals.org/article.aspx?articleid=1709803\" target=\"_blank\">Women’s Health Study\u003c/a> (WHS) released Monday is the first to examine how every-other-day use of low-dose aspirin specifically affects cancer in women, said Nancy Cook an author on the paper.\u003c/p>\n\u003cp>The researchers chose to use a low-dose of aspirin to minimize the drug’s side effects.\u003c/p>\n\u003cp>Until now, there has been little information about what dose of aspirin might be needed to prevent cancer.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The WHS enrolled almost 40,000 women in a decade-long aspirin experiment. Half of the women took a low-dose of aspirin (100mg) every other day. The other half was given placebo. Over the 18 year study, women who took aspirin reduced their risk of colon cancer by about 20 percent.\u003c/p>\n\u003cp>At the end of 10 years, Cook and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15998890\" target=\"_blank\">compared\u003c/a> the aspirin-takers with those that took the sugar pills. But they didn’t see any difference in cancer rates between the groups.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>I\u003c/strong>n previous studies that hinted at a cancer-preventing role of aspirin, participants were often given high doses of the drug. Even then, many of those benefits came with a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21144578\">delay\u003c/a> -- 5 or 10 years after starting the regimen.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>So the research team continued to follow 34,000 of the original women and tracked their health for roughly 8 more years. Then they did the comparison again.\u003c/p>\n\u003cp>“I wasn’t expecting to see [an] effect on colorectal cancer at all. Our initial results had been null,” said Cook, a professor at Boston's Brigham and Women’s Hospital and Harvard Medical School. But “right after we published the [initial] results of the trial, those curves begin to separate.”\u003c/p>\n\u003cp>Those results are published in this latest study. Among the group of women who took a low-dose of aspirin, there were fewer cases of colorectal cancer. “That was really surprising,” Cook added.\u003c/p>\n\u003cp>Katherine Van Loon, a gastrointestinal oncologist at UCSF sounded downright enthusiastic when I talked to her on the phone. The study is \"incredibly robust,\" she said. “The sample size [of nearly 40,000 women] and the long duration of follow up are really exceptional,” she added.\u003c/p>\n\u003cp>The jury is still out on aspirin’s effect on other cancers, including breast and lung. To date, research findings have been inconsistent and the WHS didn’t find any effect for other types of cancer.\u003c/p>\n\u003cp>Exactly how aspirin may prevent colon cancer is still a mystery, and scientists also don’t clearly understand the reason behind the delay.\u003c/p>\n\u003cp>“It seems that those [studies] with higher doses [of aspirin] tended to find the effect earlier,” said Cook.\u003c/p>\n\u003cp>But people wary of cancer may want to exercise caution before stocking up on a year’s supply of aspirin.\u003c/p>\n\u003cp>Higher doses of aspirin can lead to more side effects, and the study found that even a low dose of aspirin put people at greater risk of gastrointestinal bleeding and peptic ulcers.\u003c/p>\n\u003cp>In rare instances, aspirin can cause gastrointestinal hemorrhage, which could lead to hospitalization and blood transfusions, said Cook.\u003c/p>\n\u003cp>“Drugs that work come with a risk,” said Bruce Hammock, a professor in both UC Davis’ Comprehensive Cancer Center and the Entomology Department (it turns out chemical pathways in insects are very similar to those in humans). Doctors should ask patients if they have \"a tendency toward GI bleeding,\" Hammock said. “If you do, you would run away from aspirin.”\u003c/p>\n\u003cp>On the other hand are patients with a family history of colon cancer or a genetic pre-disposition to form gastrointestinal tumors. “These data say to me that that cohort of people would probably be a lot better off taking a baby aspirin,” said Hammock.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, each person must weigh the risks and benefits of their personal health history with their doctor and watch for possible complications when using any drug.\u003c/p>\n\n","blocks":[],"excerpt":"We've known for years that the lowly over-the-counter aspirin not only relieves headaches, but it can also reduce your risk of heart attack and stroke. Now researchers have demonstrated aspirin can do even more: it may prevent cancer, specifically colon cancer in women.\r\n\r\nThere has been mounting evidence that links aspirin use to lower rates of cancer, particularly gastrointestinal cancers like colon cancer. Yet, few studies have set out to directly ask whether aspirin actually reduces cases of cancer.\r\n","status":"publish","parent":0,"modified":1374605701,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":23,"wordCount":769},"headData":{"title":"Headaches, Heart Disease, Stroke; Can Aspirin Prevent Cancer, Too? | KQED","description":"We've known for years that the lowly over-the-counter aspirin not only relieves headaches, but it can also reduce your risk of heart attack and stroke. Now researchers have demonstrated aspirin can do even more: it may prevent cancer, specifically colon cancer in women.\r\n\r\nThere has been mounting evidence that links aspirin use to lower rates of cancer, particularly gastrointestinal cancers like colon cancer. Yet, few studies have set out to directly ask whether aspirin actually reduces cases of cancer.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Headaches, Heart Disease, Stroke; Can Aspirin Prevent Cancer, Too?","datePublished":"2013-07-16T00:15:56.000Z","dateModified":"2013-07-23T18:55:01.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"13654 http://blogs.kqed.org/stateofhealth/?p=13654","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/07/15/headaches-heart-disease-stroke-can-aspirin-prevent-cancer-too/","disqusTitle":"Headaches, Heart Disease, Stroke; Can Aspirin Prevent Cancer, Too?","path":"/stateofhealth/13654/headaches-heart-disease-stroke-can-aspirin-prevent-cancer-too","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_13656\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-13656\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/aspirin_ThinkStock-620x586.jpg\" alt=\"(Photo: Getty Images)\" width=\"620\" height=\"586\">\u003cfigcaption class=\"wp-caption-text\">(Photo: Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>We've known for years that the lowly over-the-counter aspirin not only relieves headaches, but it can also reduce your risk of heart attack and stroke. Now researchers have demonstrated aspirin can do even more: it may prevent cancer, specifically colon cancer in women.\u003c/p>\n\u003cp>There has been mounting \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/22036019\" target=\"_blank\">evidence\u003c/a> that links aspirin use to lower rates of cancer, particularly gastrointestinal cancers like colon cancer. Yet, few studies have set out to directly ask whether aspirin actually reduces cases of cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Over the 18 year study, women who took aspirin reduced their risk of colon cancer by about 20 percent.\u003c/aside>\n\u003cp>Results from the \u003ca href=\"http://annals.org/article.aspx?articleid=1709803\" target=\"_blank\">Women’s Health Study\u003c/a> (WHS) released Monday is the first to examine how every-other-day use of low-dose aspirin specifically affects cancer in women, said Nancy Cook an author on the paper.\u003c/p>\n\u003cp>The researchers chose to use a low-dose of aspirin to minimize the drug’s side effects.\u003c/p>\n\u003cp>Until now, there has been little information about what dose of aspirin might be needed to prevent cancer.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The WHS enrolled almost 40,000 women in a decade-long aspirin experiment. Half of the women took a low-dose of aspirin (100mg) every other day. The other half was given placebo. Over the 18 year study, women who took aspirin reduced their risk of colon cancer by about 20 percent.\u003c/p>\n\u003cp>At the end of 10 years, Cook and her colleagues \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/15998890\" target=\"_blank\">compared\u003c/a> the aspirin-takers with those that took the sugar pills. But they didn’t see any difference in cancer rates between the groups.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>I\u003c/strong>n previous studies that hinted at a cancer-preventing role of aspirin, participants were often given high doses of the drug. Even then, many of those benefits came with a \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmed/21144578\">delay\u003c/a> -- 5 or 10 years after starting the regimen.\u003cstrong>\u003c/strong>\u003c/p>\n\u003cp>So the research team continued to follow 34,000 of the original women and tracked their health for roughly 8 more years. Then they did the comparison again.\u003c/p>\n\u003cp>“I wasn’t expecting to see [an] effect on colorectal cancer at all. Our initial results had been null,” said Cook, a professor at Boston's Brigham and Women’s Hospital and Harvard Medical School. But “right after we published the [initial] results of the trial, those curves begin to separate.”\u003c/p>\n\u003cp>Those results are published in this latest study. Among the group of women who took a low-dose of aspirin, there were fewer cases of colorectal cancer. “That was really surprising,” Cook added.\u003c/p>\n\u003cp>Katherine Van Loon, a gastrointestinal oncologist at UCSF sounded downright enthusiastic when I talked to her on the phone. The study is \"incredibly robust,\" she said. “The sample size [of nearly 40,000 women] and the long duration of follow up are really exceptional,” she added.\u003c/p>\n\u003cp>The jury is still out on aspirin’s effect on other cancers, including breast and lung. To date, research findings have been inconsistent and the WHS didn’t find any effect for other types of cancer.\u003c/p>\n\u003cp>Exactly how aspirin may prevent colon cancer is still a mystery, and scientists also don’t clearly understand the reason behind the delay.\u003c/p>\n\u003cp>“It seems that those [studies] with higher doses [of aspirin] tended to find the effect earlier,” said Cook.\u003c/p>\n\u003cp>But people wary of cancer may want to exercise caution before stocking up on a year’s supply of aspirin.\u003c/p>\n\u003cp>Higher doses of aspirin can lead to more side effects, and the study found that even a low dose of aspirin put people at greater risk of gastrointestinal bleeding and peptic ulcers.\u003c/p>\n\u003cp>In rare instances, aspirin can cause gastrointestinal hemorrhage, which could lead to hospitalization and blood transfusions, said Cook.\u003c/p>\n\u003cp>“Drugs that work come with a risk,” said Bruce Hammock, a professor in both UC Davis’ Comprehensive Cancer Center and the Entomology Department (it turns out chemical pathways in insects are very similar to those in humans). Doctors should ask patients if they have \"a tendency toward GI bleeding,\" Hammock said. “If you do, you would run away from aspirin.”\u003c/p>\n\u003cp>On the other hand are patients with a family history of colon cancer or a genetic pre-disposition to form gastrointestinal tumors. “These data say to me that that cohort of people would probably be a lot better off taking a baby aspirin,” said Hammock.\u003cstrong> \u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, each person must weigh the risks and benefits of their personal health history with their doctor and watch for possible complications when using any drug.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/13654/headaches-heart-disease-stroke-can-aspirin-prevent-cancer-too","authors":["1462"],"categories":["stateofhealth_13"],"tags":["stateofhealth_193","stateofhealth_461"],"featImg":"stateofhealth_13656","label":"stateofhealth"},"stateofhealth_4886":{"type":"posts","id":"stateofhealth_4886","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"4886","score":null,"sort":[1334005451000]},"guestAuthors":[],"slug":"talking-about-choices-may-encourage-colon-cancer-screening","title":"Talking About Choices May Encourage Colon Cancer Screening","publishDate":1334005451,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n","blocks":[],"excerpt":"Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\r\n\r\nThe problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. Alternatives do exist, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, new tools are also being developed that use more advanced science to check for markers of cancer, though these are still gaining traction.","status":"publish","parent":0,"modified":1334005545,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":721},"headData":{"title":"Talking About Choices May Encourage Colon Cancer Screening | KQED","description":"Although about 50,000 people in the U.S. died from colorectal cancer (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\r\n\r\nThe problem is getting people to undergo screening can be a bit of a challenge. The "ick" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. Alternatives do exist, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, new tools are also being developed that use more advanced science to check for markers of cancer, though these are still gaining traction.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Talking About Choices May Encourage Colon Cancer Screening","datePublished":"2012-04-09T21:04:11.000Z","dateModified":"2012-04-09T21:05:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"4886 http://blogs.kqed.org/stateofhealth/?p=4886","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/04/09/talking-about-choices-may-encourage-colon-cancer-screening/","disqusTitle":"Talking About Choices May Encourage Colon Cancer Screening","path":"/stateofhealth/4886/talking-about-choices-may-encourage-colon-cancer-screening","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By: Kamal Menghrajani\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_4913\" class=\"wp-caption alignleft\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012.jpg\">\u003cimg class=\"size-medium wp-image-4913\" title=\"Doctor greating patient\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/04/DoctorPatientPic_FlickrVicLawrence_April92012-300x200.jpg\" alt=\"Doctor greating patient\" width=\"300\" height=\"200\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Patient-doctor discussions about choices in colon cancer screening may encourage more people to follow through. (Vic Lawrence: Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Although about 50,000 people in the U.S. \u003ca href=\"http://seer.cancer.gov/statfacts/html/colorect.html\">died from colorectal cancer\u003c/a> (CRC) last year, as many as half of those deaths could have been prevented by routine screening. That’s 25,000 lives that could have been saved using tools that are already widely available.\u003c/p>\n\u003cp>The problem is getting people to undergo screening can be a bit of a challenge. The \"ick\" factor of colonoscopies, concerns about paying for them, and other barriers get in the way of adequate screenings. \u003ca href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\">Alternatives do exist\u003c/a>, such as the fecal occult blood test (FOBT) – a non-invasive test people can do at home and send into the lab. As reported here in the past, \u003ca href=\"../2012/02/23/avoiding-a-colonoscopy-youre-not-alone/\">new tools are also being developed\u003c/a> that use more advanced science to check for markers of cancer, though these are still gaining traction.\u003c/p>\n\u003cp>But now doctors are looking at the psychology of how they talk to patients to figure out what might get the most people to get on board with screening.\u003c/p>\n\u003cp>In a study published today in the \u003ca title=\"http://archinte.ama-assn.org/\" href=\"http://archinte.ama-assn.org/\" target=\"_blank\">Archives of Internal Medicine\u003c/a>, researchers from three medical schools, including \u003ca title=\"http://www.ucsf.edu/\" href=\"http://www.ucsf.edu/\" target=\"_blank\">UCSF\u003c/a>, focused on just colonoscopies and FOBT. The study was done in San Francisco through the\u003ca title=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" href=\"http://www.sfdph.org/dph/comupg/oservices/medSvs/\" target=\"_blank\"> Community Health Network\u003c/a>, and randomized doctors into three study groups: one to recommend only FOBT, one to recommend only colonoscopy, and one to offer patients a choice between the two.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Researchers presumed that recommending just one or the other would send a clear signal and be more effective than giving patients a choice.\u003c/p>\n\u003cp>They were wrong.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>What they found instead was that patients who were recommended to get a colonoscopy only followed through 38 percent of the time. Compare that to patients who got a recommendation for FOBT and got screened 67 percent of the time, or those given a choice between the two -- who underwent screening 69 percent of the time.\u003c/p>\n\u003cp>As the researchers say, “Giving choices through shared decision making can improve adherence by increasing patient engagement and allowing for individual patient preferences.”\u003c/p>\n\u003cp>The finding was surprising because previous studies had suggested that talking to patients about the wide range of available options often led them to do nothing at all. As the study authors put it, “[E]vidence also illustrates that providing options of similar value and characteristics can sometimes have a negative impact on adherence due to people defaulting to inertia, presumably because of confusion or indecision between choices.”\u003c/p>\n\u003cp>Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California, wrote a commentary in response to the publication. In his words:\u003c/p>\n\u003cblockquote>\u003cp> “If having too many choices leads to confusion, the study by Inadomi et al. demonstrates that not having enough choice may lead to inaction when the only choice is colonoscopy ... When it comes to CRC screening, providing an option other than colonoscopy for our patients is not overwhelming, but necessary.”\u003c/p>\n\u003cp>“What should physicians recommend when talking with patients about CRC? The psychology literature has noted that too much choice is a problem in current society. Patients may be overwhelmed by the options and feel that no option is perfect and therefore choose to do nothing out of confusion. However, every option for CRC screening has its own unique strengths and limitations. A patient-centered approach would take each patient’s perspective into account when designing a screening strategy.”\u003c/p>\u003c/blockquote>\n\u003cp>The study further looked at differences among groups of people to find barriers to screening. The authors wrote:\u003c/p>\n\u003cblockquote>\u003cp>“Prior studies reported low CRC screening rates among racial/ethnic minorities, especially among Asians, Latinos, and African Americans. While the present study confirms the disparity among African Americans, we observed higher adherence among Asians and Latinos than for whites. Our population had established access to health care, which may have reduced these racial differences.”\u003c/p>\u003c/blockquote>\n\u003cp>The study authors also found that people who did their patient-doctor visits in Spanish, Cantonese, or Mandarin were more likely to get screened than people of the same race/ethnicity who chose to do their visits in English.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>And, not surprisingly, patients with insurance (public or private) completed screening more often than those without insurance.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/4886/talking-about-choices-may-encourage-colon-cancer-screening","authors":["8344"],"categories":["stateofhealth_12","stateofhealth_14"],"tags":["stateofhealth_82","stateofhealth_193","stateofhealth_236"],"label":"stateofhealth"},"stateofhealth_3255":{"type":"posts","id":"stateofhealth_3255","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"3255","score":null,"sort":[1330040485000]},"guestAuthors":[],"slug":"avoiding-a-colonoscopy-youre-not-alone","title":"Avoiding a Colonoscopy? You're Not Alone","publishDate":1330040485,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_3269\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock.jpg\">\u003cimg class=\"size-medium wp-image-3269 \" title=\"colonoscope-thinkstock\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock-300x449.jpg\" alt=\"\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If the sight of a colonoscope like this one makes you shudder, there are other options for colorectal cancer screening.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" target=\"_blank\">Colorectal cancer\u003c/a> is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" target=\"_blank\"> successful\u003c/a> screening method--it cuts the death rate of colorectal cancer in half.\u003c/p>\n\u003cp>Still, getting a colonoscopy has a problem: the yuck factor. That's why a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" target=\"_blank\"> study\u003c/a> in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. FIT--fecal immunochemical testing--looks for the presence of blood in the stool, a marker for benign polyps or cancer. Patients have either one colonoscopy during the ten years of the study or FIT every other year. (Note that the \u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" target=\"_blank\">American Cancer Society \u003c/a>has a great explainer of the different screening methods available and pros and cons of each).\u003c/p>\n\u003caside class=\"pullquote alignleft\">“In order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.”\u003c/aside>\n\u003cp>In today's study researchers say colonoscopy and FIT detected roughly the same number of cancers. The report comes at the two year point of what will be a ten year study. We have to wait the full ten years to see how death rates from colorectal cancer compare between the two types of screening.\u003c!--more-->\u003c/p>\n\u003cp>In the meantime, some interesting factoids that hint at the yuck factor popped up in the breakdown of which patients participated in which screening. Fully 94 percent of patients who responded to an invitation to participate in the FIT trial completed the test. But in the colonoscopy group, the rate dropped to 67 percent. In addition, more than 20 percent of the people who were assigned to colonoscopy opted for FIT instead. Apparently, they weren't so interested in having a colonoscopy. But they WERE interested in being screened.\u003c/p>\n\u003cp>For a little perspective on the study, I called Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California. \"What's clearly shown here,\" he told me, \"is that in order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For the last several years, Kaiser Permanente has been making aggressive strides to screen its own patient population. Individual doctors may still continue to recommend colonoscopy to patients ages 50 to 75 -- the recommended ages for colorectal cancer screening. But Levin says that Kaiser wanted something they could mail out -- something that people could do at home, then mail back to the lab. Kaiser put in place an automated system of phone calls and reminder postcards to encourage people to complete the FIT test and send it in. Unlike the study in Spain, Kaiser recommends patients get a FIT test every year, instead of every other year.\u003c/p>\n\u003cp>The effort has been working. Levin says Kaiser has seen their colorectal cancer screening rates \"march up.\" In 2011, 80 percent of its members ages 50 to 75 had been screened, he says. About twice as many people had FIT as colonoscopy\u003cstrong>\u003c/strong>. And the screening appears to be leading to earlier diagnosis. \"We're diagnosing much earlier stage cancers and fewer of them,\" Levin says. \"Two hundred fewer colon cancer in 2010 than in 2009 across Northern California Kaiser, even with membership growth.\"\u003c/p>\n\u003cp>Levin cautions that he is waiting for one more year of data to be sure Kaiser is on the right track. As for cost, Levin also believes the screening will save money. \"Cost of treating advanced colon cancer keeps getting more expensive, so we think any way you can get people screened is a cost saving endeavor through the whole cycle of screening through treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Choice in screening also speaks to the importance of patient decision-making. \"We're definitely making a difference,\" Levin says, \"and we'll be most effective in giving patients what they want, instead of telling them what they need.\"\u003c/p>\n\n","blocks":[],"excerpt":"Colorectal cancer is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a successful screening method--it cuts the death rate of colorectal cancer in half.\r\n\r\nStill, getting a colonoscopy has a problem: the yuck factor. That's why a study in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. ","status":"publish","parent":0,"modified":1343769825,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":11,"wordCount":685},"headData":{"title":"Avoiding a Colonoscopy? You're Not Alone | KQED","description":"Colorectal cancer is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a successful screening method--it cuts the death rate of colorectal cancer in half.\r\n\r\nStill, getting a colonoscopy has a problem: the yuck factor. That's why a study in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus "FIT," a non-invasive test to screen for colorectal cancer. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Avoiding a Colonoscopy? You're Not Alone","datePublished":"2012-02-23T23:41:25.000Z","dateModified":"2012-07-31T21:23:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3255 http://blogs.kqed.org/stateofhealth/?p=3255","disqusUrl":"https://ww2.kqed.org/stateofhealth/2012/02/23/avoiding-a-colonoscopy-youre-not-alone/","disqusTitle":"Avoiding a Colonoscopy? You're Not Alone","path":"/stateofhealth/3255/avoiding-a-colonoscopy-youre-not-alone","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_3269\" class=\"wp-caption alignleft\" style=\"max-width: 200px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock.jpg\">\u003cimg class=\"size-medium wp-image-3269 \" title=\"colonoscope-thinkstock\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/02/colonoscope-thinkstock-300x449.jpg\" alt=\"\" width=\"200\" height=\"300\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">If the sight of a colonoscope like this one makes you shudder, there are other options for colorectal cancer screening.\u003c/figcaption>\u003c/figure>\n\u003cp>\u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/OverviewGuide/colorectal-cancer-overview-what-is-colorectal-cancer\" target=\"_blank\">Colorectal cancer\u003c/a> is one of the five most common cancers in both men and women, and it kills more than 43,000 Americans each year. As we learned today, colonoscopy is a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1100370?query=featured_home\" target=\"_blank\"> successful\u003c/a> screening method--it cuts the death rate of colorectal cancer in half.\u003c/p>\n\u003cp>Still, getting a colonoscopy has a problem: the yuck factor. That's why a\u003ca title=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa1108895?query=featured_home\" target=\"_blank\"> study\u003c/a> in today's New England Journal of Medicine caught my eye. Researchers in Spain looked at colonoscopy versus \"FIT,\" a non-invasive test to screen for colorectal cancer. FIT--fecal immunochemical testing--looks for the presence of blood in the stool, a marker for benign polyps or cancer. Patients have either one colonoscopy during the ten years of the study or FIT every other year. (Note that the \u003ca title=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" href=\"http://www.cancer.org/Cancer/ColonandRectumCancer/DetailedGuide/colorectal-cancer-detection\" target=\"_blank\">American Cancer Society \u003c/a>has a great explainer of the different screening methods available and pros and cons of each).\u003c/p>\n\u003caside class=\"pullquote alignleft\">“In order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.”\u003c/aside>\n\u003cp>In today's study researchers say colonoscopy and FIT detected roughly the same number of cancers. The report comes at the two year point of what will be a ten year study. We have to wait the full ten years to see how death rates from colorectal cancer compare between the two types of screening.\u003c!--more-->\u003c/p>\n\u003cp>In the meantime, some interesting factoids that hint at the yuck factor popped up in the breakdown of which patients participated in which screening. Fully 94 percent of patients who responded to an invitation to participate in the FIT trial completed the test. But in the colonoscopy group, the rate dropped to 67 percent. In addition, more than 20 percent of the people who were assigned to colonoscopy opted for FIT instead. Apparently, they weren't so interested in having a colonoscopy. But they WERE interested in being screened.\u003c/p>\n\u003cp>For a little perspective on the study, I called Dr. Theodore Levin, who heads up Colon Cancer Screening for Kaiser Permanente in Northern California. \"What's clearly shown here,\" he told me, \"is that in order to get a large proportion of a population screened, you have to offer an alternative to colonoscopy.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For the last several years, Kaiser Permanente has been making aggressive strides to screen its own patient population. Individual doctors may still continue to recommend colonoscopy to patients ages 50 to 75 -- the recommended ages for colorectal cancer screening. But Levin says that Kaiser wanted something they could mail out -- something that people could do at home, then mail back to the lab. Kaiser put in place an automated system of phone calls and reminder postcards to encourage people to complete the FIT test and send it in. Unlike the study in Spain, Kaiser recommends patients get a FIT test every year, instead of every other year.\u003c/p>\n\u003cp>The effort has been working. Levin says Kaiser has seen their colorectal cancer screening rates \"march up.\" In 2011, 80 percent of its members ages 50 to 75 had been screened, he says. About twice as many people had FIT as colonoscopy\u003cstrong>\u003c/strong>. And the screening appears to be leading to earlier diagnosis. \"We're diagnosing much earlier stage cancers and fewer of them,\" Levin says. \"Two hundred fewer colon cancer in 2010 than in 2009 across Northern California Kaiser, even with membership growth.\"\u003c/p>\n\u003cp>Levin cautions that he is waiting for one more year of data to be sure Kaiser is on the right track. As for cost, Levin also believes the screening will save money. \"Cost of treating advanced colon cancer keeps getting more expensive, so we think any way you can get people screened is a cost saving endeavor through the whole cycle of screening through treatment.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Choice in screening also speaks to the importance of patient decision-making. \"We're definitely making a difference,\" Levin says, \"and we'll be most effective in giving patients what they want, instead of telling them what they need.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/3255/avoiding-a-colonoscopy-youre-not-alone","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_82","stateofhealth_193"],"label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. 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