A Black-owned radio station, a physician, and a quest to prevent colon cancer
Black Americans are more likely to get colorectal cancer—and even more likely to die from the disease—than any other racial or ethnic group in the United States. And while Black people experience health disparities across a host of diseases, colorectal cancer is largely preventable through screening. Furthermore, at-home stool testing kits—which take just a few minutes to administer and don't require colon prep or a visit to the doctor's office—are as valid a form of screening as a colonoscopy for many people.
That was the premise behind a unique community-based campaign that Penn Medicine joined this year with WURD, Philadelphia's Black-owned and -operated talk radio station, and other organizations to provide free fecal immunochemical testing (FIT) kits and follow-up support to Philadelphia residents.
At-home testing kits use a stool sample collected by the patient to test for blood, which can be a sign of polyps or cancer in the colon or rectum. For people without additional risk factors, the at-home kits can be as effective as a colonoscopy in preventing cancer if done every year.
Participating in the WURD campaign was part of a multi-year campaign by Penn Medicine to raise colorectal cancer screening rates—and follow-up care—starting with getting at-home testing kits to more community members. Other Penn Medicine-involved efforts included drive-through fairs where testing kits were handed out, and mailed-home kits for Penn Medicine patients in targeted zip codes.
For the WURD campaign, Akinbowale Oyalowo, MD, MSHP, a gastroenterologist at Penn Presbyterian Medical Center (PPMC) and assistant professor of gastroenterology at the Perelman School of Medicine at the University of Pennsylvania, approved eligible patients to receive the testing kits and followed up with those for whom a colonoscopy was recommended. He also appeared on a panel during the "Evening WURDS" show, one of several events the station organized to promote the "Go to Know" campaign. Listeners were directed to a website where they could register for a kit.
"It's like online shopping, but instead of buying a gift for yourself or someone else, it's a gift for your health," Oyalowo said.
After listeners registered for the kits, they were contacted by a patient navigator from the Colorectal Cancer Alliance to determine if they met the criteria for at-home testing or should have a colonoscopy instead. The Independence Blue Cross Foundation covered the cost of kits for anyone with that insurance and the Colorectal Cancer Alliance paid for the rest.
WURD's role was critical in reaching Black Philadelphians, said Oyalowo, who has a research interest in increasing colorectal cancer screenings, particularly in vulnerable populations and in community-based settings.
"We have a responsibility to be invested in the health of our residents," he said. "If you want a community-based intervention to not only have a higher chance of succeeding, but have a higher chance of being a durable, long-term intervention, it needs to be in cooperation with leaders and individuals in that community."
Founded by a Black physician, WURD has a track record of getting community members involved in public health campaigns. The station played a critical role in getting more than 10,000 Black participants enrolled in a study by Penn's Scheie Eye Institute to understand glaucoma, which affects Black people at five times the rate of whites. With the colon cancer campaign, the station leaders believed that "even if we just reach one person and change the trajectory of their life this would be a success," said Sara Lomax-Reese, WURD's president and CEO and daughter of the founder.
"When you execute a health education campaign in an environment where people are predisposed to trust and believe you, then it goes down a lot smoother and there's less skepticism," Lomax-Reese said. "And when you have African-American physicians and African-American colon cancer survivors and Black people who are experts to further break it down and explain it, that eliminates the barrier of distrust."
The WURD campaign ran from March through October. As of early October, 145 kits had been distributed and about 18 percent of people who were identified as either having symptoms or colon cancer risk factors, and where a colonoscopy was advised. Countless others learned about the disease and how to prevent it.
"I think it has been a large success. In the research literature, there aren't many papers that describe this kind of direct outreach for cancer screening," Oyalowo said. "With interventions to increase cancer screenings, you need interventions at different levels. Some are short-term, some are long-term, some are structural, some are more individual-focused. And you really do need all of them in conjunction to move these numbers."