MHFV Blog Colonoscopy Gaps
Across the nation and within M Health Fairview, 15 percent fewer African American adults are coming in for colon cancer screenings. We launched an initiative this fall to try and reduce that gap by improving access and outreach.

Commitment to Equity, Health and Wellness, News and Events

Discovering the causes of colon cancer screening disparities – so we can solve them

Colorectal cancer is common – and preventable. M Health Fairview launched an initiative this fall to ensure all patients have the support they need to get screened on time.

  • October 22, 2021
  • By Staff Writer

Colorectal cancer is one of the most common cancers in the United States, and a leading cause of cancer-related deaths. It’s also largely preventable with proper screening.

There is a significant gap nationwide between African American and white patients when it comes to colorectal cancer screening. The National Institutes of Health reported that 15 percent fewer African American adults are coming in for screening

We’ve seen a similar gap for M Health Fairview patients. That’s why we launched a new initiative this fall, designed to cut the systemwide colorectal cancer screening gap between African American and white patients in half.

“We want to dive in and figure out why we’re seeing that gap. Then, we can work on closing it,” said Huy Nguyen, RN, who is leading the initiative. “Colorectal cancer screening is one of the most intensive preventive visits. We’re hoping that what we find out here can then help us close gaps in less invasive screenings for breast cancer, sexually-transmitted diseases, and other illnesses.”

Nguyen designed and launched the project this fall. He chose to begin with the gap between African American and white patients because it was by far the largest across M Health Fairview.

He and his team are reviewing data from our clinics, researching the primary causes of this screening gap. He suspects some of it has to do with the social determinants of health. These are factors in a person’s life that can significantly impact health and healthcare access. They include education, income, and food security, among other areas.

“We know that screening rates are lower in our immigrant communities. We know that patients with significant economic barriers aren’t getting preventive care as often,” said M Health Fairview Colon and Rectal Surgeon Genevieve Melton-Meaux, MD, PhD. “To know the specific factors preventing an individual patient from coming in for a colonoscopy, you have to know that individual patient. A lot of our work will be centered around outreach, building trust and access.”

Melton-Meaux also serves as chief analytics and care information officer for M Health Fairview. In this role, she leads care map initiatives to provide reliable, evidence-based care. This work aims to improve outcomes for patients and reduce health disparities.

She is working with Nguyen to review existing data, using those findings to then create solutions for reducing the existing screening gap. One of the steps we’ve already taken, and something we’ll continue to work on through this research, is improving patient outreach. Many health systems – ours included – send out reminders when a person should come in for a routine colonoscopy. But in many cases, a patient’s family member is listed as the primary contact – especially for non-English speaking households – or a person may have forgotten to update their contact information.

“We’re thinking about how to more effectively contact people who move frequently, or have a family member listed as their contact,” said Nguyen. “We may not see these same challenges for English-speaking, non-foreign-born patients.”

There have also been changes recently to colorectal cancer screening guidelines. It’s on the rise in younger patients, especially those under 50 years old. Everyone is now recommended to come in as soon as they turn 45, and those at higher risk may want to start screening earlier.

There are also multiple screening options. People at normal risk for colorectal cancer can choose to do a stool test instead of a colonoscopy. These are performed either annually or every three years, depending on the type of test. As a health system, it’s our job to educate the community on new guidelines and tests in a culturally competent way.

“Colonoscopy is still the gold standard, but we can also collect a stool sample. It’s an easier test, less invasive, but you have to do it more often,” said Melton-Meaux. “We’re working with our providers, educating them on how to have these conversations with different communities.”

“We want to provide optimal care for our patients – the right care for the right patient at the right time,” added Nguyen. “Reducing colorectal cancer screening gaps is just one piece of the puzzle. It’s something we can build off, and a way that we can build trust with our communities.”