ASGE recently hosted its second National Colorectal Cancer (CRC) Screening Summit to discuss
ways to increase the CRC screening rate for underserved patients in the US.
The September 23 online event included more than 40 of the nation’s leading CRC screening
experts who represent an array of key stakeholders, including gastroenterologists and other
physicians and allied health care professionals, health care system representatives, insurers
as well as advocacy groups.
ASGE gave an update on its CRC Screening Project, which is designed to increase the followup
colonoscopy rate for underserved people who have an abnormal stool-based CRC
“The follow-up colonoscopy rate for underserved patients who have an abnormal stoolbased
CRC test result is only 50 percent to 70 percent,” says Jennifer Christie, MD, MASGE,
ASGE’s immediate past president and the chair of the project’s blue ribbon advisory council.
“This project is so crucial and has the potential to save so many lives.”
Dr. Christie notes that ASGE’s project is also aimed at reducing the amount of time it takes
for patients who have an abnormal stool-based CRC test result to get a follow-up
colonoscopy – understanding that it is imperative to do so in less than 10 months given the
higher risk of CRC and advanced stage disease – and gaining a better understanding of the
barriers that exist for patients and health care professionals.
One of Dr. Christie’s fellow advisory council members, Pegah Hosseini-Carroll, MD, FASGE,
stresses that, “We know that people on the lower end of socioeconomic scale are more
likely to get colorectal cancer regardless of other risk factors, and an earlier diagnosis can
help address racial and ethnic disparities and increase survival.”
She says today’s CRC screening barriers can include cost, insurance, logistics, fear and
anxiety, cultural factors, the lack of transportation as well as poor health care system
processes and communications.
When it comes to the best ways to increase the follow-up colonoscopy rate, Dr. Hosseini-
Carroll reports that there is widespread support for increasing the use of CRC quality metrics
and developing a universal data set for the Centers for Medicare & Medicaid Services to
track CRC screening and care.
ASGE’s CRC Screening Project includes developmental projects in Georgia and Maryland.
The organization is working with Community Health Care Systems, Inc. (CHCS), which is a
federally qualified health center (FQHC) that will help hundreds of patients in middle Georgia
get screened for CRC using a stool-based DNA test. Professional navigators from Horizons
Community Solutions will assist patients who have an abnormal stool-based CRC test result
through the full continuum of care, including a timely follow-up colonoscopy and other
applicable care if it’s required.
“We’ve already had more than 50 patients sign up for the ASGE project since July,” says
CHCS CEO Carla Belcher. “And of the 12 patients who have completed a stool-based CRC test
to date, four have had an abnormal result. Subsequently, Horizons Community Solutions will
be helping those patients schedule a follow-up colonoscopy as a next step.”
The Maryland project is being administered by MedChi Network Services. It includes two
primary care practices – IC Care Corporation (George Bone, MD) and Menocal Family
Practice (Julio Jose Menocal, MD) – and a gastroenterologist (Alpha Banks, MD). Hundreds
of patients are also expected to be screened in Maryland, and the effort may be expanded
to include public health departments.
The ASGE project will cover the cost of follow-up colonoscopies and bowel prep products,
and patients who need care beyond a follow-up colonoscopy will be assisted in finding
access to that care (e.g., emergency Medicaid).
“Once we analyze the quantitative and qualitative data we’ve collected, we will develop a
playbook and model public policy that can be used to increase the follow-up colonoscopy
rate for underserved patients in other states,” explains Tonya Adams, MD, a member of the
ASGE advisory council. “Our goal is to be in a position to market the playbook and promote
the project’s outcomes with policymakers, the medical profession, advocacy organizations,
the media and other key stakeholders in the 2026 timeframe.”
It is also worth noting that ASGE is advocating for sources of sustainable state funding to
pay for timely follow-up colonoscopies for underserved people who have abnormal stoolbased
CRC test results in Georgia and Maryland in 2025 and beyond.
“CRC is the leading cause of cancer death in men under 50 and the second leading cause of
cancer death in women who are under 50,” says Dr. Christie, emphasizing that, “The good
news is that CRC also has a 90 percent survival rate when it’s detected early enough, which
is why ASGE is appealing to everyone who is 45 or older to get screened.”
The ASGE project is mainly funded by an unrestricted grant from Exact Sciences, with
additional support from Ironwood Pharmaceuticals and Sebela Pharmaceuticals’ Braintree
ASGE’s first National CRC Screening Summit took place in August 2023.
Visit
ASGE.org/CRC for information on ASGE’s CRC Screening Project.