Patients Seeing High-Quality PCPs Are More Likely to Receive Colon Cancer Screening

By Nate Freese
October 17, 2017

Grand Rounds is committed to partnering with employers to connect their employees with the highest quality physicians. In evolving our physician quality algorithm, our Data Science team is continually evaluating physicians’ clinical practice patterns, and the results paint a stark portrait of medicine today.

COLORECTAL CANCER SCREENING: Not all primary care physicians are created equal.

Each year, 50,000 people in the U.S. die from colorectal cancer, making it the second deadliest form of cancer.1 In many of these cases, preventive screening could have have made all the difference. Public health organizations universally recommend that all men and women over the age of 50 undergo routine colonoscopies or alternative screening procedures, yet one-third of Americans over 50 do not receive these screenings at the recommended frequency.2,3 A shocking 28% of people have never received any form of colon cancer screening.4

The importance of colon cancer screening is hard to overstate. Early detection dramatically alters a patient’s prognosis: five-year survival rates are 9x higher (90% vs 10%) if the cancer is detected at an early stage, before it spreads to other organs.5 Early-stage colon cancer typically has no symptoms, though, so preventive screening is usually the only way to identify the disease when it is still highly treatable. As a result, the National Institutes of Health considers colon cancer screening one of the most important yet widely underused preventive screenings available.6

The biggest reason for not getting screened? Simple lack of communication between patients and their doctor. When people understand the risk of colon cancer and the benefits of screening, the vast majority of patients get tested. In many cases, though, patients have never had this conversation with their physician. According to a study by the American Journal of Preventive Medicine, patients report that the top two barriers to colon cancer screening were “a clinician’s failure to suggest screening and not knowing testing was necessary.”7

Our analysis of colon cancer screening rates affirms this notion. Specifically, we find that patients seeing top-rated PCPs are almost 15% more likely to receive screening than patients seeing PCPs who are rated in the bottom decile.

Consider the implications of this difference. Studies suggest that every 10% increase in screening could reduce colon cancer deaths by almost 4%. This would translate to 1,900 lives saved per year.8

As this variation in screening rates illustrates, a person’s choice of PCP can have far greater impact than most of us tend to imagine. Of the more than one million people who are set to develop this cancer over the next decade, most are active and healthy today.9 Their choice of doctors may not seem that important right now. It is.

Using more than seven billion data points, Grand Rounds has assessed over 96% of practicing physicians in the United States to identify the highest quality doctors in each specialty. As an employer, partnering with Grand Rounds can help your employees find physicians with the skill and judgment needed to guide your employees on the best clinical path.

Read additional analyses in the Grand Rounds Data Insights series here.

Source

  1. “Common Cancer Types,” National Cancer Institute, https://www.cancer.gov/types/common-cancers
  2. “Underuse of Surveillance Colonscopy in Patients at Increased Risk of Colorectal Cancer,” Am J Gastroenterol, http://www.nature.com/ajg/journal/v110/n5/full/ajg2014344a.html?foxtrotcallback=true
  3. “Vital Signs: Colorectal Cancer Screening Test Use – United States, 2012,” Centers for Disease Control and Prevention, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6244a4.htm
  4. “Vital Signs: Colorectal Cancer Screening Test Use – United States, 2012,” Centers for Disease Control and Prevention, https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6244a4.htm
  5. “Consumer Reports: Colorectal cancer deaths could be cut with preventive action,” Consumers Union of United States Inc., https://www.washingtonpost.com/national/health-science/consumer-reports-colorectal-cancer-deaths-could-be-cut-with-preventive-action/2011/11/30/gIQAAx7eBR_story.html?utm_term=.0d119df85f55
  6. “The Importance of Colorectal Cancer Screening,” David E. Beck, MD, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3307509/
  7. “The Relative Importance of Patient-Reported Barriers to Colorectal Cancer Screening,” American Journal of Preventive Medicine, http://www.ajpmonline.org/article/S0749-3797(10)00097-8/abstract
  8. “Consumer Reports: Colorectal cancer deaths could be cut with preventive action,” Consumers Union of United States Inc., https://www.washingtonpost.com/national/health-science/consumer-reports-colorectal-cancer-deaths-could-be-cut-with-preventive-action/2011/11/30/gIQAAx7eBR_story.html?utm_term=.295c05f36834
  9. Annual colorectal cancer incidence is currently 135,000 based on SEER estimates: “Cancer Stat Facts: Colon and Rectum Cancer,” National Cancer Institute, https://seer.cancer.gov/statfacts/html/colorect.html
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