Using race to reduce incidence of cancer

For years, HealthPartner's clinics have sent out reminders to patients to get a colonoscopy when they turn 50.

Now, they are combing through medical records to identify black patients and urge them to get the test even younger: starting at 45.

The program, announced Thursday, was started because blacks are at higher risk than whites of dying from colon cancer, and earlier screening can save lives, said Dr. Brian Rank, a cancer specialist and medical director of HealthPartners Medical Group.

It is also one of the first medical organizations in the nation to use racial information about patients to customize their medical care, Rank said.

"Right now, many of our rules are one size fits all," he said. But that's starting to change.

Last year, the American College of Gastroenterology recommended that blacks get the colon-cancer screening at age 45 instead of 50, which is recommended for other groups.

"Nationally, colorectal cancer deaths are 48 percent higher among African-Americans than among Caucasians," Rank said. He said HealthPartners decided to do something about it, as part of its campaign to reduce health disparities.

Using electronic medical records, the clinics can automatically identify patients by race and age, and generate electronic messages telling them it is time for a test.

Come on in for a colonoscopy

This month, HealthPartners began using the data to send a new message to blacks 45 and over: You're due for a colonoscopy.

It's too early to tell how well it's working, Rank said.

But Gloria Lewis, Minnesota's former director of minority and multicultural health, said it could make a huge difference. "Early warnings are essential," she said.

Rank says HealthPartners used the same information to discover that racial minority members were getting fewer mammograms than other women. As a result, the clinics started a campaign to make breast-cancer screening more accessible, and offered same-day appointments at its mammography sites. The effort paid off, he said, cutting the disparity between white and nonwhite patients in half, from about 12 percent to 6 percent.

Eventually, Rank says, the clinics will be able to use patient data to customize medical care even further, based on such things as family history.

"This starts us down a road of highly personalized recommendations for your health," he said. "It helps people understand what their risks are, and what their choices are."