Theodore Levin, MD

Gastroenterology, KP Diablo Service Area

Colorectal Cancer Screening Program

“This program leverages the advantages of Permanente Medicine—a focus on prevention, our electronic medical record, and integration across specialties—to screen more patients for colorectal cancer, and ultimately prevent more cancers and cancer deaths.”

Colorectal cancer is the third most common cancer and the second leading cause of cancer deaths among adults in the United States. Yet when caught early through regular screening, the 5-year relative survival rate is approximately 90%.

Thanks to the work of Theodore Levin, MD, clinical lead for colorectal cancer screening, more than 80% of Kaiser Permanente Northern California members are up to date on their colorectal cancer screenings—one of the highest rates in the nation. Fifteen years ago, however, the story was very different.

“When we began generating reports in 2004 based on electronic data, we discovered that just 35% of our members were up to date,” says Dr. Levin. “We thought we had screened a lot of people with flexible sigmoidoscopy, and we were disappointed that compliance was that low.”

Based on research he conducted at the KP Division of Research, it appeared the new fecal immunochemical test (FIT), which patients can complete at home, would be an effective and easier option for patients. 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.

After his study demonstrating the FIT’s effectiveness was published in the Journal of the National Cancer Institute in 2007, Dr. Levin spear-headed a program to put the test in the hands of every patient aged 50 to 75 across KP Northern California.

“Today 15,000 FIT kits are mailed to patients’ homes each week,” Dr. Levin says. “Those who haven’t completed their screenings receive follow-up calls, and are prompted by doctors and support staff at each visit.”

Because of the increased screening rates in KP Northern California, more precancerous polyps are being detected, and more of the colorectal cancer that is found is being diagnosed in earlier stages. These accomplishments have led to a 25% decrease in the incidence of colorectal cancer and a 50% decrease in mortality, respectively.