Ms. Butt Meddler, the singing and dancing gastroenterologist, tells African Americans to Start at 45.

African Americans have a high rate of new colorectal cancers and they are diagnosed earlier in life. And their death rate is higher than the rest of the US population. The American College of Gastroenterology guidelines call for them to be screened beginning when they are 45.

Patricia Raymond MD, AKA Ms. Butt Meddler, sings and dances and recommends that blacks start screening at 45, rather than 50.

Dr. Raymond is a board-certified gastroenterologist who “. . .takes medicine seriously and herself lightly.”  She tells people who are afraid of colonoscopy to Laugh Their Fears Away at Colonjoke.net.

And if you haven’t watched and laughed at Ms Butt Meddler’s Looking Up My Back Door, enjoy!

Making those New Year’s Resolutions?

You can do a lot to prevent colon and rectal cancer this year . . . and in the future.

Number One Resolution — Be screened for colorectal cancer if you are 50 or over, earlier if you are at higher risk. Read the rest of this entry »

A patient navigator who speaks the patient’s language and has time to spend answering questions and removing barriers makes a difference in whether that patient will get colorectal screening.

A study in Boston randomly assigned community patient navigators to half of a diverse group of low-income patients who were behind in colorectal cancer screening.  Compared to patients who received usual health care, patients who got help from a patient navigator were more likely to complete screening, have a colonoscopy, and have polyps detected and removed. Read the rest of this entry »

After a normal colonoscopy when no polyps are found, guidelines call for a repeat test in 10 years.

However, almost half of Medicare patients with a negative colonoscopy got another exam within 7 years, and for one in four there was no clear evidence that they needed one.

Because colonoscopies have real risks and are expensive, over-testing can be both dangerous and costly. Given limited numbers of physicians who do colonoscopies, unecessary procedures add to long waiting lists for screening and for necessary follow-up exams.

Although Medicare regulations call for reimbursement only after 10 years in cases where the first procedure didn’t find a problem, payments are being made for earlier exams.  In fact, Medicare denied payment for only 2 percent of colonoscopies for which there was no clear indication of need. Read the rest of this entry »

Colorectal cancer screening rates for colorectal cancer improved between 2000 and 2008 for white, black and Asian-Americans aged 50 and over—but barely improved for Hispanics and actually worsed for American Indians and Alaska Natives.

The latest statistics, just reported by the federal Agency for Healthcare Research and Quality on March 23, found that:

• In 2008, among adults aged 50 or over, about 60 percent of whites reported ever having been screened (up from 51 percent in 2000);
• About 55 percent of blacks and Asian Americans had been screened at least once (compared to 44 percent in 2000);
• In the same age group, only 44 percent of Hispanics reported ever having been screened (slightly increased from just 35 percent in 2000), even though this population has the third-highest death rate from colorectal cancer;
• Screening rates actually decreased among American Indians and Alaska Natives, to only 37 percent in 2008 (compared to 41 percent in 2000).

Among people without health insurance, screening rates were significantly lower in all ethnic groups:

• Among both whites and blacks with no health insurance, the at-least-once screening rate was about 30 percent (increased barely from 26% in 2000);
• Screening worsened to an abysmal 13 percent (down from 16 percent in 2000) among Hispanics with no health insurance.

In summary, even among those with insurance, only half—and often far fewer—people over age 50 are getting even one screening. Among the uninsured, screening is just not being done for a cancer that can be prevented or cured if caught early.

Source: Agency for Healthcare Research and Quality, 2010 National Healthcare Quality and Disparities Reports