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Bringing Down the Barriers

Carmen-GuerraSaving Lives with a Colonoscopy

Two eye-opening facts:

  • * The average lifetime risk in this country of getting colon cancer is six percent, but when a pre-cancerous polyp is present, the lifetime risk increases by three to five times
  • * Stage 1 colon cancer has a 90-percent survival rate after five years. At Stage 4 -- when the cancer has spread to other organs -- survival plummets to less than 10 percent.

A colonoscopy will not only find these pre-cancerous polyps, but also remove them, basically eliminating the risk.  And yet, for a variety of reasons, many people avoid it.

According to Carmen Guerra, MD, of Medicine, some of the barriers that keep people away often stem from a lack of knowledge.  “People think a colonoscopy is painful [which it’s not], they think patients are put under general anesthesia [which, in the majority of cases, they’re not] and men have told us that colonoscopy takes their manhood away…. It’s a combination of knowledge, beliefs and attitudes.”

There can be socioeconomic factors as well. For example, people can’t afford the cost of the test or the bowel prep, and do not have a way to get to the hospital and back home.

Penn-Med-CAREs-blue-newTo help overcome the many obstacles -– and improve the colon cancer screening rates -– Guerra, along with Michael Kochman, MD, of Medicine, launched the West Philadelphia GI Health Outreach and Access Program. The target population: UPHS patients, 50 and over, who live in one of five West Philadelphia zip codes (19104,19131,19139, 19151) and have failed to keep at least one appointment for a colonoscopy. 

Guerra said this population -- mostly African Americans -- are 20 percent more likely to develop colon cancer than Caucasians and 45 percent more likely to die from the illness.

Alicia Lamanna became the program’s patient navigator, working one-on-one with patients to overcome obstacles that might prevent them from getting a screening and then walking them through the entire process.  Since starting the program last year, 148 patients have come for a colonoscopy. And of that number, “37 percent had at least one significant polyp removed that could have become cancer,” Guerra said. “In the average population, only about 10 percent will have an extremely concerning polyp.”

In addition, three of the patients were found to have colorectal cancer and were referred to the Abramson Cancer Center for treatment.

“Being able to assemble this program with the help of Dr. Guerra and Alicia has been extraordinarily gratifying,” Kochman said. “It has allowed us to provide needed care to our local citizens and is a great example of the collaboration between the University, foundations, and private philanthropy.”

The Penn Medicine CAREs grant Guerra received, along with seed funding from an anonymous donor and funding from multiple foundations,* will help the program continue to reach out and save lives. “It’s an incredibly effective program,” she said. “We are helping people who need it most.”

To learn more about the program, call 215-439-8281 or go to and search the news blog for “GI Outreach.”

*The West Philadelphia GI Access and Outreach Program has received support from Wal-Mart and the American Cancer Society for the Community Health Empowerment Program, the Colon Cancer Alliance Community Partnership Grant, Get Your Rear in Gear, the Penn Presbyterian Medical Center’s Bach Fund and from the Haverford School Checking For Cancer program.


Photo caption: (L. to r.): Alicia Lamanna, Michael Kochman, and Carmen Guerra help improve colon cancer screening rates in West Philadelphia through their GI Health Outreach and Access program.

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