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Structured colorectal cancer screening program eliminates disparities between Blacks and Whites

Colorectal cancer disparities between Black and White adults were eliminated among members of a Northern California health care organization after it instituted a regionwide, structured colorectal cancer screening program.

In 2009, the colorectal cancer death rate (per 100,000) was 54.2 for Black members and 32.6 for white members. By 2019, death rates had fallen by more than half among Black members — decreasing to 20.9 — compared to 19.3 for white members, essentially eliminating the previous disparity.

Colorectal cancer incidence also markedly decreased with similar rates seen between Black and white members, according to the study conducted by Chyke A. Doubeni, MD, (above) and his colleagues.

The colorectal cancer screening program instituted by Kaiser Permanente in 2006-2008 identifies who needs screening and offers a choice of screening tests. Program managers and electronic systems identify all eligible members who are not up to date and automated alerts remind health care providers to offer screening at clinic visits. For members who are not up to date with screening, a fecal immunochemical test (FIT) is mailed annually. These tests are completed at home and returned by mail. Patients can request a colonoscopy, rather than use a FIT kit.