These Temple doctors are on a mission to cut colonoscopy wait times by getting people to test their own stool

Temple University Hospital patients will be able to walk through a giant inflatable colon this Wednesday and learn about the dangers of colon cancer. Anyone 45 years or older will receive a free at-home stool testing kit.

The kits are part of a Temple Health project to detect colorectal cancer earlier by getting more people in the community tested.

Colonoscopies are highly effective in screening for colorectal cancer, but getting one can be a challenge for people who aren’t able to take time off work or get a ride. Others are nervous about the procedure, which involves being put under anesthesia so a doctor can use a camera at the end of a long, flexible tube to scan the colon. People usually must first see a primary care doctor for a referral, and may wait up to 10 months for a colonoscopy appointment.

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But a simple stool test can flag people who are at high risk and direct them to seek additional testing. Temple physicians are handing out stool tests in grocery stores, the hospital lobby, and at neighborhood events.

“What really precludes us from handing these tests at other visits or in the lobby or in the neighborhood shop?” said Claire Raab, an internal medical physician who leads the stool testing project. “The answer was actually nothing.”

The initiative is designed to improve access to screening in a community where doctors worry residents are at higher risk of colon cancer.

Black Americans are more likely to get colorectal cancer and to die from it. And people who are covered by Medicaid, and live in neighborhoods with higher poverty rates, have less access to primary care. That means that many people who live in the North Philadelphia neighborhoods around Temple are less likely to find a lesion in their the colon before it develops into cancer.

“What we are doing is taking care to them,” said Rishabh Khatri, an internal medicine chief resident involved with the project.

Colorectal cancer is common and deadly, but preventable. About 1 in 23 men and 1 in 25 women will develop the disease, according to the American Cancer Society, which estimates that 53,000 people will die from the cancer this year.

Public health authorities recommend colorectal cancer screenings for all people between the ages 45 and 75. That could be through a colonoscopy every 10 years, or other less comprehensive tests — such as a CT scan — every 5 years.

People who have polyps removed during a colonoscopy or who have a history of colon cancer may need to be screened more often.

But colorectal cancer is often detected only when the disease already progressed and is difficult to treat, Raab said.

The stool test that the Temple team is handing out is called FIT, and it is similar to a COVID-19 home test.

The test includes a swab, similar to a Q-tip, that patients use to get a sample of stool from toilet paper. Then they place the swab in a tube that has liquid in it, and wait for the result.

A positive result does not equal a diagnosis of colorectal cancer, Raab said. FIT tests for hidden blood in stool, and there are many reasons for bleeding.

People with a positive result will need a colonoscopy to check for cancer.

Temple has handed out nearly 1,000 tests in about seven months. When people get an at-home test, they register their contact information so that Temple providers can follow up.

Patients with a positive test get a colonoscopy within two weeks, Raab said. Previously the wait time was six to 10 months.

“We are not saying that this is a pure alternative to a colonoscopy,” Khatri said. “We are saying that those who really need it the most should get it immediately.”