ADVOCACY SPOTLIGHT
Advocacy Plays Critical Role in Preventing Colon Cancer ASCA Board member urges ASCs to be involved BY KRISTIN MURPHY
ASCA Board Member Tom Deas, Jr, MD, began his gastroenterology med- ical practice in Fort Worth, Texas, in 1991. Board certified by the American Board of Internal Medicine in both internal medicine (1981) and gastroen- terology (1989), Deas served 20 years in the US Air Force, retiring as colo- nel, before starting his practice. Dur- ing his clinical practice, he served as the medical director of the Fort Worth Endoscopy Center and the SW Fort Worth Endoscopy Center from 1995 to 2012. In 2012, he also served as president of the American Society for Gastrointestinal Endoscopy (ASGE). In December 2014, Deas retired from Gastroenterology Associates of North Texas in Fort Worth. He now works as the vice president of physician engage- ment with North Texas Specialty Phy- sicians (IPA). He is a member of the Physician Advisory Board for Surgical Care Affiliates and was elected to the Ambulatory Surgery Center Associa- tion (ASCA) Board in 2014.
Why did you choose to be an advocate for colorectal cancer screening? DEAS: As a gastroenterologist, I found that the absolutely worst thing I had to do was advise patients waking up from a colonoscopy that they had colon cancer. If that was not bad enough, I also knew that the vast majority—up to 80 per- cent—of colon cancers can be avoided with
timely and effective screening
tests. Our modern era of medicine pro- vides physicians with the greatest satis- faction of maintaining health and pre- venting disease in addition to our more traditional role of treating and curing illness. I have seen effective colorectal cancer screening (CRCS) profoundly reduce colorectal cancer (CRC) rates in our Medicare Advantage health plan members, using primarily colonoscopy
22 ASC FOCUS MARCH 2017
The vast majority—up to 80 percent—of colon cancers can be avoided with timely and effective screening tests.”
—Tom Deas, Jr, MD, ASCA Board member
screening and fecal immunochemical testing (FIT) for those who cannot or will not have a colonoscopy.
What are the biggest barriers to patients trying to access colorectal cancer screenings? DEAS: I personally believe that the greatest barrier is patient resistance to undergoing screening tests. I under- stand that colonoscopy is a tempo- rary “big deal” for some as they fear the preparation and sedation. How- ever, getting colon cancer is a long- term big deal and occurs in 1 in 20 people. Colonoscopy is required only every 10 years in the majority of patients who have a normal examina-
tion soon after age 50. For the 25–30 percent with colon adenomas (polyps) who are at higher risk for developing colon cancer, the intervals might be shorter depending on the number, size and type of polyps. For the uninsured and underserved, cost and access to care are barriers to screening as well. If colonoscopy is not a consideration, annual FIT testing is readily available and very low cost. For many it might be offered free by community health centers, health fairs and some health systems. However, even when FIT is sent to at-risk populations at no cost to the patient, the adherence rate can be very low, often less than 20 percent.
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