Theodore Levin, MD

Colorectal cancer is the second leading cause of cancer death in this country. Yet convincing patients to get screened can be one of the biggest challenges primary care physicians and gastroenterologists face. To remedy this and improve patient health, Dr. Levin and Douglas Corley, MD, a gastroenterologist at KP San Francisco, developed a colorectal cancer (CRC) screening program in TPMG and studied its effects.

Each physician played a critical role in the research. Dr. Levin led the launch of the screening program team in 2006, which mails fecal immunochemical tests (FIT) to the home of every patient aged 50 to 75 across KP Northern California. The test checks for blood in the stool, an indicator that precancerous polyps or cancer may be present, and only positive FIT results require a follow-up colonoscopy. Patients who do not complete the test receive follow-up calls. Dr. Corley led the KP Division of Research team of coordinators, data analysts, and biostatisticians who studied CRC screening uptake, incidence, and mortality by analyzing data from all patients in KP Northern California eligible for screening from 2000 to 2015.

Drs. Levin and Corley discovered a remarkable impact. CRC screening rates in KP Northern California went from 39% in 2000 to nearly 83% in 2015—even in the face of a 50% increase in the eligible patient population. Within that same time period, mortality from colorectal cancer declined by 52%, and incidence decreased by 26%.

Their study, published in Gastroenterology in 2018, received national recognition, including from the National Colorectal Cancer Round Table (NCCRT). They’ve been praised not only for their successes, but also for creating a roadmap to help others attain screening rates of 80%, which the NCCRT set as a national goal in 2013, to be achieved by 2018. TPMG had already reached it in 2011.