By Janet Byron
Thanks to the work of the Division of Research’s Theodore (TR) Levin, MD, more than 80 percent of Kaiser Permanente Northern California members are up to date on their colorectal cancer screenings—one of the highest rates in the nation.
Levin, a gastroenterologist in Kaiser Permanente’s Diablo Service area and clinical lead for colorectal cancer screening, is one of four recipients of The Permanente Medical Group’s 2018 Sidney R. Garfield Exceptional Contribution Awards, for his pioneering efforts to expand colorectal cancer screening across Kaiser Permanente’s Northern California region. The award is named for Sidney R. Garfield, MD, the physician-founder of Kaiser Permanente and one of the great innovators of 20th-century American health care delivery.
Colorectal cancer is the third most common cancer and the second-leading cause of cancer deaths among adults in the United States. Yet when caught early through regular screening, the 5-year relative survival rate is approximately 90 percent.
Levin’s efforts to improve colorectal cancer screening began 15 years ago.
“When we began generating reports in 2004 based on electronic data, we discovered that just 35 percent of our members were up to date,” Dr. Levin said. “We thought we had screened a lot of people with flexible sigmoidoscopy, and we were disappointed that compliance was that low.”
Based on research he conducted at the Division of Research, it appeared the new fecal immunochemical test (FIT), which patients can complete at home, would be an effective and easier option for patients. The test checks for blood in the stool, an indicator that precancerous polyps or cancer may be present, and only positive FIT results require a follow-up colonoscopy.
After his study demonstrating the FIT’s effectiveness was published in the Journal of the National Cancer Institute in 2007, Dr. Levin spearheaded a program to put the test in the hands of every patient aged 50 to 75 across Kaiser Permanente Northern California.
“Today 15,000 FIT kits are mailed to patients’ homes each week,” Dr. Levin said. “Those who haven’t completed their screenings receive follow-up calls, and are prompted by doctors and support staff at each visit.”
Because of the increased screening rates in Kaiser Permanente Northern California, more precancerous polyps are being detected, and more of the colorectal cancer that is found is being diagnosed in earlier stages. These accomplishments have led to a 25 percent decrease in the incidence of colorectal cancer and a 50 percent decrease in mortality, respectively.
A version of this article originally appeared on The Permanente Medical Group website. Click here to see a video about Dr. Levin and the Kaiser Permanente Northern California colorectal cancer screening program.