CIGNA HealthCare Battles Colorectal Cancer

Main Category: Colorectal Cancer
Also Included In: GastroIntestinal / Gastroenterology
Article Date: 27 Jun 2007 - 0:00 PDT

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Because more than six percent of CIGNA HealthCare members in Florida who participated in a pilot screening program for colorectal cancer last year had test results that revealed abnormalities -- signaling the need for follow-up tests with their doctors -- CIGNA HealthCare expanded the program significantly over the past year. More than 320,000 CIGNA HealthCare members received InSure(R) fecal immunochemical test (FIT) kits from CIGNA with the support of Quest Diagnostics Incorporated (NYSE: DGX). The test helped CIGNA members screen at home for gastrointestinal bleeding which is often an early indicator for potentially deadly colorectal cancer.

Barry Wilkins of Seffner, Fla., is one of the CIGNA HealthCare members whose life was changed when he took the test. "I feel extremely lucky to have been included in CIGNA's program last year. I had a colonoscopy three years ago and thought I was all set, so when I received the InSure test kit, I almost ignored it," said Wilkins. "At the last minute, I decided to take the test and to my surprise I ultimately discovered I had colon cancer. Because CIGNA sent me the kit without my even having to ask for it, my cancer was caught early enough to be treated. I consider myself so fortunate because who knows what would have happened had I waited for my next colonoscopy in two years."

In the expanded program, 1,016 people, or 6.7 percent of the members who returned the InSure test kit had positive results and required follow-up testing from their physicians. "Most people do not realize that screening for colorectal cancer can be a simple process because of tests like InSure," said Dr. Dick Salmon, CIGNA HealthCare National Quality Medical Director. "Colon cancer is preventable and treatable and can be detected at a stage where effective treatments are available, which is why we want to encourage our members to undergo screening for colon cancer. This program can help save lives," he continued.

CIGNA expanded the screening initiative to 13 states: Ariz., Ga., Ill., Ind., Kan., Mo., N.J., N.Y., Ohio, Pa., S.C., Tenn., and Texas. The program targets members who are 50 years of age or older and overdue for a screening. The initiative included a message from NCCRA co-founder Katie Couric emphasizing the value of screening and early detection of colorectal cancer. Various approaches were used to compare various strategies to encourage members to be screened for colorectal cancer. The goal was to encourage members to complete and submit the simple screening test and share the results with their physicians.

Dr. Graeme Young, Chair of the Colorectal Cancer Screening Committee of the World Organization of Digestive Endoscopy, and Professor of Gastroenterology at Flinders University in South Australia said of CIGNA's Colorectal Cancer Screening Program, "For the first time, physicians have valid research on the effectiveness and costs associated with various approaches to providing in-home screening tests. CIGNA's research in improving colorectal cancer screening by directly engaging consumers with an in-home screening test is making a valuable contribution to our understanding of how to improve early detection of colon cancer, resulting in improved screening rates and the potential to save lives."

CIGNA HealthCare Senior National Medical Director Dick Salmon, MD, PhD was invited to present CIGNA's colorectal cancer screening program at the May 19, 2007 session of the World Organisation of Digestive Endoscopy's (Organisation Mondiale d'Endoscopie Digestive (OMED) Colorectal Cancer Screening Committee's meeting at the Digestive Disease Week (DDW)) Conference in Washington, DC. Dr. Salmon's presentation was given to 60 world and industry leaders on various testing options designed to address individual preferences with the goal of increasing colorectal cancer screening rates. His topic was "Uptake of mailed fecal immunochemical technology when case-finding fails." Other presenters on the panel were from Germany, France, Canada, England and the United States.

OMED is an international non-profit world federation of national societies committed to promoting the study and advancement of digestive endoscopy for diagnosis and treatment of gastro-intestinal diseases. It meets alongside the DDW conference which is the largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

Patients with colon cancer detected at its earliest and most treatable stage have a 90 percent chance of five-year survival, according to the American Cancer Society (ACS). However, only 39 percent of the cases are diagnosed at an early stage. And according to the ACS, "Colorectal cancer is one of the few cancers that can be prevented through screening." Still, more than 50,000 Americans die from colon cancer each year.

Quest Diagnostics, one of CIGNA's nationally contracted laboratory providers, offers the InSure FIT, an FDA-cleared test, for use in screening for colorectal cancer and other sources of lower gastrointestinal bleeding. A recent study reported in the November 1, 2006 American Cancer Society journal Cancer comparing the new FIT for colorectal cancer screening to the older guaiac fecal occult blood test (GFOBT) sampling techniques concludes, "this brush sampling FIT is significantly better at detecting advanced neoplasias than a sensitive GFOBT." The study goes on to say, "It can be anticipated that the better relative detection rate for InSure, through its better sensitivity for adenomas, would have a greater impact on mortality and incidence rates."

The ACS recommends colorectal cancer screening for all men and women 50 years old and older. Yet, the national screening rate in this age group among insured individuals averages only 53 percent, according to the National Committee for Quality Assurance. Although the screening rate for CIGNA's members over age 50 is slightly higher than this national average, the company wants to further improve the screening rates through the expanded program.

Included in the mailing is Katie Couric's "Picture of Health" public service announcement, which was developed and produced by the Centers for Disease Control and Prevention's (CDC's) Screen for Life: National Colorectal Cancer Action Campaign, in partnership with the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance, which Couric co-founded in 2000.

Members receiving the test also receive guidance about what to do if they have specific symptoms of colorectal cancer such as a change in bowel habits, rectal bleeding or abdominal pain, which would require a complete evaluation by a physician. Members may also visit http://www.insuretest.com for additional information on the test. The confidential test results are mailed to the members, who are encouraged to share the results, whether positive or negative, with their primary care physicians so that an appropriate follow-up screening plan may be developed.

CIGNA HealthCare
http://www.cigna.com

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