Yesterday & Today
Making Cancer Screening Easier
By Sue Rochman
On paper, colonoscopy may be the best colorectal cancer screening test. But in the real world, says Heather M. Brandt, a social and behavioral scientist at the University of South Carolina in Columbia, the procedure’s bowel prep, cost and time keep many people from getting one. And that’s more true in communities that are medically underserved than anywhere else.
Brandt and her colleagues at the university’s Center for Colon Cancer Research recently joined other major organizations to launch a program that pairs patients in these communities with “screening navigators.” These professionals guide patients step-by-step through the entire process of getting a colonoscopy—from scheduling an appointment to learning about the kinds of follow-up they may need. Patients pay nothing for their colonoscopies or the navigation service.
Since the program was launched in November 2011, Renay Caldwell, a screening navigator in the Columbia area, has already helped more than 40 people obtain a colonoscopy. Caldwell greets each new client with water, a granola bar and palpable enthusiasm. “I tell them, ‘I’m your personal tour guide and my job is to make sure you have a good experience. Your job is to arrive [at your colonoscopy] well-prepped so that you have a good experience and so that you can tell others in your community that this is something they need to get done.’ ”
The navigation program recruits patients from four free clinics that cover dozens of counties in South Carolina. None of Caldwell’s patients has a household income more than 25 percent above the state’s poverty line, and most have never had someone provide this type of personalized medical care.
Caldwell uses videos, pictures, written materials and humor to explain the benefits of colorectal cancer screening, how a colonoscopy is performed, and proper bowel preparation. Her success rate is high: Only two of her patients have not shown up for their colonoscopies. What’s more, a number have already referred friends and family members to her. “This is not only navigation,” she says, “it’s educating a community.”