A doctor examines patient medical records. [Illustrative].
(photo credit: INGIMAGE)
Although early diagnosis of precancerous polyps in the large intestine can prevent deadly colorectal cancer, a new study has found that many of those with signs of blood in the stool don’t go for a colonoscopy to detect and remove growths.
The study, funded by the National Institute for Health Policy Research and based on a phone survey of members of the Meuhedet and Maccabi health funds, found that early diagnosis after occult blood was found in stool samples “falls between the chairs.” The research was conducted by Liora Velinsky, Revital Azoulay, Dr. Einat Elran and Dr. Fabian Hershkowitz.
More than 60% of Israelis aged 50-74 take the advice of their health funds and perform a home screening test for the early detection of colorectal cancer. Yet about 33% of those with a positive result don’t go for a colonoscopy.
The researchers wanted to find out what prevented people with positive results from doing anything about those results and why their physicians did not get involved in ensuring a follow-up.
The retrospective data was an analysis of follow-up among 45,281 members of the two health funds who received a positive result of occult blood in the stool between 2010 and 2015. They focused on 745 patients who received a positive result from an occult blood test in 2016. Of these, 40% told the researchers they were not aware of a positive result, while another 14% said they didn’t remember undergoing the test or that occult blood was found in the stool.
The researchers did not find any connection between the patients’ following up their positive results and how long they had to wait for a colonoscopy (availability) or how far they lived from a medical facility that performs them (accessibility). The poor and Arabs were at a significantly higher risk by not following up their results. There was a significant correlation between patients’ understanding of the findings and follow-up, but no connection was found with the age, gender, religiosity, marital status or the profession of the person who gave the patient the results.
The research team found it was not clear who is responsible for ensuring that patients with occult blood go for a colonoscopy. Even general practitioners and family physicians had too little awareness about the extent of the problem. “It is essential to address these issues, to work toward improvement of patient literacy and to make sure that there is a continuum of treatment in the health fund,” they concluded.