Dr. Monica L. Baskin directs community outreach and engagement and leads screening and prevention studies to overcome barriers to screening and early detection of cancer in underrepresented minority and rural populations across the UPMC Hillman Cancer Center network.
Since March is Colorectal Cancer Awareness Month, we asked Baskin, director of community outreach and engagement at UPMC Hillman, a few questions about ways to lower the risks.
A recent American Cancer Society study showed that Americans have not rebounded to pre-pandemic levels for cancer screenings – although colorectal cancer screenings were an exception to that, thanks to at-home testing. What do you believe are the reasons behind this decline?
I believe some people are still recovering from major negative impacts of the COVID pandemic, including job loss, underemployment, grief from loss of family and friends, among other personal issues, which may be complicating a “return to normal.”
Some may still be concerned about risk of exposure to COVID, particularly in the clinical setting. Others may have simply forgotten about routine cancer screenings, particularly if they did not have an annual physical or other medical appointment where a provider would be reminding and asking about screening.
What efforts are underway at UPMC Hillman Cancer Center to encourage people to get screened for colon cancer?
We are actively adding more community outreach events to educate the public about the need for cancer screening. We are collaborating with our partners, particularly in medically underserved areas where return to pre-COVID screening rates have not happened, to ensure availability of at-home colorectal screening tests. We are also personally navigating those who may need follow-up diagnostic screening. We are doing this for all cancer screening, not just colorectal screenings.
While colonoscopy is the standard screening tool for colorectal cancer, there are also at-home tests, which many believe are helping to increase the screening rate for this cancer. Are you seeing this?
Yes, people of average risk, who are those with no personal or family history of colorectal cancer, or no symptoms, can certainly take advantage of home-based testing that may be more convenient. They are easy to administer in the comfort and privacy of your home. The tests are then sent by mail for processing and analysis. If there is a positive finding from the home-based test, it is critical to follow up with a diagnostic screening or colonoscopy. Again, we are here to help navigate that process.
What are you doing to help eliminate fear of these screenings and of health care as a whole?
Our trained community outreach, engagement and navigation staff offer education to the public in the way of presentations, written materials and direct one-on-one conversations. We explain the value of colorectal cancer screening and emphasize that this is one of the most preventable cancers if it is detected early. Early detection is the key. When I talk with people, I also tell them my personal story of losing my father to colon cancer when he was only 51 years old, and I was just a senior in high school. I talk about how my fear of leaving my daughters too soon is much greater than the fear I had before my first colonoscopy. I hope that my story resonates as potential inspiration to others.
What are the signs that someone may need to be tested?
We promote colorectal cancer screening for those without symptoms. It is what you do before you know you have an issue. Starting at age 45, for those at average risk, this can be done with an at-home test, flexible sigmoidoscopy, or colonoscopy. However, if you have rectal bleeding or blood in your stool, persistent changes in bowel habits that include diarrhea, constipation, change in consistency, persistent pain or discomfort in the abdomen, general weakness or fatigue, or unexplained weight loss, then you should consult your primary care provider who may suggest further evaluation.
How can people prevent colon cancer? Does diet play a role in this?
Some lifestyle behaviors can help lower your risk of colorectal cancer, including:
• regular physical activity
• a diet high in fruit and vegetables
• a high-fiber and low-fat diet, or a diet low in processed meats
• maintaining a healthy weight, or losing weight for those with obesity
• limiting alcohol consumption
• avoiding tobacco use
Where can people get screened?
They can speak with their primary care physician about home-based kits or referral for colonoscopy. They can also contact the UPMC Hillman Prevention and Early Detection Center at 412-623-1266 to schedule an appointment. We partner with several free and low-cost clinics, including the Birmingham Free Clinic.
Is there anything else people should know about colorectal cancer?
This is one of the most preventable cancers we know of. Please find out your family history, and then talk with your doctor about when you should start screening and which test is right for you.
For more information, please visit hillman.upmc.com.