Episode 370: Colorectal Cancer Screening, Early Detection, and Disparities

“The five-year relative survival rate for localized, or cancer that is confined to the colon or the rectum, is 91% for colon cancer and 90% for rectal cancer. Distant, metastasized to other organs—the five-year survival rate is 13% for colon and 18% for rectal cancer. So that really shows you the huge difference in screening and where screening can come in and make better outcomes,” ONS member Kris Mathey, DNP, APRN-CNP, AOCNP^®, gastrointestinal medical oncology nurse practitioner at The James Cancer Hospital of The Ohio State University Wexner Medical Center, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about colorectal cancer screening.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by July 4, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Leaners will report an increase in knowledge related to colorectal screening, early detection, and disparities.

Episode Notes

• Complete this evaluation for free NCPD.
• ONS Podcast™ episode: Episode 153: Metastatic Colorectal Cancer Has More Treatment Options Than Ever Before
• ONS Voice articles:
• AI-Assisted Colonoscopy Can Detect Small Colon Polyps
• As Colorectal Cancer Incidence Increases in Younger Patients, USPSTF Issues New Screening Guidelines. Here’s How Nurses Can Encourage Uptake
• Colorectal Cancer Prevention, Screening, Treatment, and Survivorship Recommendations
• Text Messaging Reduces Disparities in Colorectal Cancer Screening
• USPSTF Recommends Colorectal Cancer Screening Should Begin at 45
• Clinical Journal of Oncology Nursing articles:
• Colorectal Cancer in Young Adults: Considerations for Oncology Nurses
• Colorectal Cancer Screening: A Quality Improvement Initiative Using a Bilingual Patient Navigator, Mobile Technology, and Fecal Immunochemical Testing to Engage Hispanic Adults
• Oncology Nursing Forum article: Disparities in Cancer Screening in Sexual and Gender Minority Populations: A Secondary Analysis of Behavioral Risk Factor Surveillance System Data
• ONS Course: Prevention, Detection, and the Science of Cancer—Oncology RN
• ONS Biomarker Database
• ONS Colorectal Cancer Learning Library
• American Cancer Society colorectal cancer resources
• Colorectal Cancer Alliance

To discuss the information in this episode with other oncology nurses, visit the ONS Communities.

To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [e-mail].

Highlights From This Episode

“Interestingly, recent studies suggest that starting screening even earlier than 45, such as age 40, could significantly reduce mortality and incidence rates, especially as colorectal cancer is rising among younger adults.” TS 2:42

“[Artificial intelligence]-enhanced screening tools are also being developed to improve sensitivity, reduce turnaround time, and enable real-time monitoring of disease progression. These innovations aim to make screening more accessible and accurate, especially in our underserved populations. So there’s a huge impact on early detection.” TS 4:07

“Those with multiple chronic conditions or limited mobility may be less likely to complete screening, and those results may be harder to interpret. I mentioned a little bit earlier about our underserved or minority populations. Those barriers such as limited health literacy, lack of insurance, and cultural stigma can reduce screening uptake and ultimately follow-through.” TS 12:25

“Patient navigation programs—this is where we have trained navigators to help patients schedule appointments, understand procedures, and ultimately overcome some of these logistical hurdles. These have actually been shown to significantly boost screening rates. Also, those mailed stool-based-test kits—sending those kits directly to a patient home, especially with a personalized letter from a provider to add that extra little touch, has proven effective in increasing participation.” TS 21:29

“Our screening can detect cancer before symptoms appear and even identify precancerous polyps, which can be removed to prevent cancer altogether. Studies actually show that regular screening can reduce colorectal cancer mortality by up to 35% and the incidence of advanced-stage disease by nearly 30%. Just another reason why screening really does matter.” TS 25:53

“Evaluating our implicit bias, especially in something as critical as colorectal cancer, requires both introspection and instructional supports. One way of doing this is by auditing your practice patterns, really looking at reviewing your own screening recommendations and follow-up rates across different patient demographics. So are there certain groups that are less likely to be offered a colonoscopy? I think some of us may have an implicit bias—you see a patient; you’re like, ‘There’s no way they’re going to agree to that, so I’m just not going to offer it.’ Where we don’t offer it, they don’t have that opportunity to decline that. That can lead to further delay. And those patterns can reveal a bias in action.” TS 28:18