Ethical Challenges Of Colorectal Screening

There are many different ethical challenges with colorectal screening, from access to care, screening methods, and treatment options. Not every person has equal access to preventative care. Education about colorectal cancer screening and access to screening tests varies by geographic location. Screening for colorectal cancer is lowest in the areas with low socioeconomic status (Macrae, 2015). Not all colorectal screening methods are available for people worldwide, so many people do not get to choose what method they want or would be medically best (van Dam & Bretthauer, 2014).

Although recent healthcare reform has helped increase the number of Americans having insurance coverage for colorectal screening, this does not mean that every American

There are several interventions within the health care system that can be implemented to help reach this goal by promoting colorectal cancer screening to decrease colorectal cancer rates. One intervention is to implement an office-based reminder system to help health care providers remember which patients are eligible for screening (American Cancer Society, 2014). Another suggested intervention is the use of patient navigators to manage referrals and help facilitate follow-up screening (American Cancer Society, 2014). There are many quality initiatives in the health care systems. Colorectal cancer screenings can be made a high priority for a quality initiative by hosting educational opportunities for staff on the importance of colorectal cancer screening, risk factors for colorectal cancer, and types of screening tests (National Colorectal Cancer Roundtable, 2016). Each health care system should set a system-wide screening goal (National Colorectal Cancer Roundtable, 2016). Every primary care provider should know their screening rates and the rates of the whole system to help improve and reach the set goals (National Colorectal Cancer Roundtable, 2016). The quality of colorectal cancer screening should also be monitored and known by the providers performing the procedures (National Colorectal Cancer Roundtable, 2016). A system should be in place to track adenomatous polyp detection rate, cecal intubation rate, and prep quality (National Colorectal Cancer Roundtable, 2016). Health care systems should improve existing practices or adopt new practices to maximize bowel prep thoroughness, eliminate no-shows, and improve scheduling by allowing open-access colonoscopy by allowing healthy,