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Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Computer-Assisted Flagging of Individuals at High Risk of Colorectal Cancer in a Large Health Maintenance
Ran Goshen1, Eran Choman1, Ayelet Ran1
1Ran Goshen, Eran Choman, Ayelet Ran, and Efrat Muller, Medial EarlySign, Kfar Malal; Revital Kariv, Gabriel Chodick, and Varda Shalev; Maccabi Institute for Research and Innovation, Maccabi Healthcare Services; Nachman Ash, Maccabi Healthcare Services, Tel-Aviv; Revital Kariv, Gabriel Chodick, and Varda Shalev, Tel Aviv University; Revital Kariv, Sourasky Medical Center; Nachman Ash, Ariel University, Ariel, Israel; and Steven Narod, Women's College Research Institute, Women's College Hospital, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Purpose:
To evaluate in a sample of adults who had been noncompliant with colorectal cancer (CRC) screening whether screening could be enhanced by an automated patient recall system based on identifying high-risk individuals using the ColonFlag test and an electronic medical record database.
Methods:
A total of 79,671 individuals who were determined to be noncompliant with current screening recommendations were identified in the Maccabi Health Services program in Israel. Their cancer risk was determined by ColonFlag using information on age, sex, and CBC results. Doctors of individuals who were flagged as high risk were notified and asked to follow up with their patients.
Results:
The ColonFlag identified 688 men and women who scored in the highest 0.87 percentile. Of these individuals, 254 had colonoscopies performed by Maccabi physicians, and 19 CRCs (7.5%) were found. An additional 15 cancers primarily identified outside of Maccabi were found through code matching.
Conclusion:
The ColonFlag test is a rapid, efficient, and inexpensive test that can be applied to scan electronic medical records to identify individuals at high risk of CRC who would otherwise avoid screening.
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