Nursing and Patient Education: Improving Colon Cancer Screening Rates in Primary Care

Compliance with colon cancer screening continues to be a challenge for many primary care practices. The American Cancer Society (2021) found that colorectal cancers are the second most common cause of cancer death in the United States. Preventative screening can help with the early detection and treatment of colorectal cancers.

Literature shows using fecal immunochemical testing or fecal occult blood testing has historically had an overall low return rate when suggested as part of the office visit (Chido-Amajuoyi, Sharma, Talluri, et al., 2019). Finding innovative ways to offer patients additional options for colorectal cancer screening can be useful in increasing compliance. Nurses play a key role in increasing compliance with disease prevention by providing education, outreach, and practice-based techniques to increase compliance with preventative health measures such as colorectal cancer screening.

This study measured colorectal cancer screening rates in a safety net primary care practice and included patients who are 45 years of age or older and who have not completed a screening colonoscopy. Registered nurses provided education on the use of the fecal immunochemical test (FIT) to patients who were due for a colorectal cancer screening. Education included collection process, mailing instructions, and follow-up steps. According to Houge et al. (2019), obtaining fecal specimens at the time of the visit is impractical; therefore, creating a path for patients to perform and send in the FIT kits from home may increase compliance.

This shared decision-making process allowed patients alternative options for colorectal cancer screening and promoted patient empowerment and satisfaction (Yeh et al., 2018). The method used in this study is a retrospective chart review of the target population to measure the response rate of those patients who were provided with a mail-in home FIT kit and findings in the chart review. The results of this study include demographic information, language, race/ethnicity, level of education, and insurance status. Additionally, the study reviewed the number of participants who had a positive screening, using the at-home FIT kit and subsequently completed or scheduled for a screening colonoscopy.

Learning outcomes
1) Define the benefits of early colorectal cancer detection for primary care patients.
2)    Identify target population for home colorectal cancer screening.
3)    Describe process for home FIT testing and the role of the nurse.

References
1)    American Cancer Society. (2021). When should you start getting screened for colorectal cancer? https://www.cancer.org/latest-...

2)    Chido‐Amajuoyi, O. G., Sharma, A., Talluri, R., Tami‐Maury, I., & Shete, S. (2019). Physician‐office vs home uptake of colorectal cancer screening using FOBT/FIT among screening‐eligible US adults. Cancer medicine, 8(17), 7408-7418.
3)    Hogue, S. R., Gomez, M. F., da Silva, W. V., & Pierce, C. M. (2019). A customized at-home stool collection protocol for use in microbiome studies conducted in cancer patient populations. Microbial ecology, 78(4), 1030-1034.
4)    Yeh, M. Y., Wu, S. C., & Tung, T. H. (2018). The relation between patient education, patient empowerment and patient satisfaction: A cross-sectional-comparison study. Applied Nursing Research, 39, 11-17