New approach reduces colon cancer deaths

A study published June 6, 2022,  in The Joint Commission Journal on Quality and Patient Safety showed that a comprehensive approach to improving colon cancer care at Kaiser Permanente in Southern California resulted in a 24% decrease in mortality over 7 years.

“If a new drug or surgical procedure reduced deaths this dramatically, it would be hailed as a major breakthrough,” said the lead author of the research, Michael Kanter, MD, professor and chair of clinical science at the Kaiser Permanente Bernard J. Tyson School of Medicine and adjunct investigator with the Kaiser Permanente Southern California Department of Research & Evaluation.

“Our comprehensive approach focused on a wide variety of care processes that extended beyond increasing rates of screening and follow-up for abnormalities — and sought to improve any care element that could increase overall survival,” Dr. Kanter said.

Colorectal cancer is the second-leading cause of cancer-related death in the United States and the third most common cancer among both men and women. The 5-year survival rate in the country is only 65%, despite the fact that colon cancer can be prevented through screening and can be cured with treatment if caught early.

This study was conducted between 2009 and 2018 as part of a stretch goal to decrease colon cancer deaths by 50% over 10 years. The team of researchers and physicians began with a literature review to identify evidence-based opportunities to reduce colon cancer deaths.

Based on that literature review and chart reviews, they designed and implemented new programs and initiatives across the Kaiser Permanente medical centers in Southern California to:

  • Improve the follow-up of patients with rectal bleeding and presumed iron deficiency anemia
  • Improve the reliability of postsurgical surveillance for cancer recurrence
  • Decrease elapsed time from surgery to chemotherapy
  • Increase surgical referrals for patients with advanced colon cancer
  • Increase the upper age limit and overall rate of colon cancer screening
  • Increase vitamin D and aspirin use
  • Monitor and increase the adenoma detection rate

“While some may try to improve survival rates by emphasizing the development of new drugs or new surgical approaches, or through care coordination, which are very worthy approaches, we decided to do it differently,” said Dr. Kanter. “We decided to comprehensively make every process change we could.”

He added, “Our initiatives and subsequent research showed that measuring and reducing colon cancer mortality is possible. It can be done here, and we believe it is worth exploring if this approach might also be successfully replicated in other health care settings,” he said. ”In particular, we believe that this approach could guide a portion of the efforts to achieve President Biden’s Cancer Moonshot goal of decreasing overall cancer mortality by 50% in the next 25 years.”