Cancer Prevention On the Road
Lynn Butterly takes colon cancer screening out into the community
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Dr. Lynn Butterly is passionate about the need for colon cancer screening. So much so that she has taken her show on the road, working with health care organizations throughout New Hampshire to provide free colon cancer education and screening fairs in local communities. Dr. Butterly is a gastroenterologist at Dartmouth-Hitchcock Medical Center. "Far too many people die of colon cancer that could have been prevented or successfully treated if caught soon enough," she says. "With the screening resources we have today, colon cancer is really a preventable disease."
Colon cancer is the second most common cause of death from cancer in the United States - almost 60,000 people die from it each year. Men and women over age 50 are more likely to develop colon cancer, and a personal or family history of colorectal cancer or precancerous polyps increases a person's risk. Regular screening tests are the most effective means of prevention and early detection, and when found early, the chances of survival are excellent.
"Our goal is to get people screened, and to heighten awareness and lessen fear around colorectal cancer screening," Butterly says. "We decided that in order to do that, we needed to get out into the communities and work with local organizations to reach people who may not have access to healthcare or see a doctor regularly, and may be less likely to get screened."
Grassroots Effort
Over the past year, Butterly has worked with nurse practitioner, Leane Matchem, DHMC's Section of Gastroenterology, and Norris Cotton Cancer Center to produce fairs throughout New Hampshire. The local health care providers and community volunteers are the people who really make the fairs work, Butterly says. "These fairs are really a grassroots effort, supported by us. We work with each community to figure out what we need to do to make it easy for people in the community to come and see us."
The fairs emphasize education, and use a combination of materials, videos, and direct teaching to inform people about colon cancer screening, the importance of diet and activity, and ways to stay healthy. Each person who comes in the door is screened for colon cancer risk factors, and Dr. Butterly sits down with anyone who is determined to be at high risk to explain the risks and advise them what to do. Often local internists and gastroenterologists attend the fairs, so Dr. Butterly is able to connect high-risk individuals to a physician right then and there.
Each fair participant is taught how to use the take-home hemoccult screening kit, which can be mailed back for analysis at DHMC at no charge. Results of the test are sent to all participants, as well as their primary care physicians.
Improving Screening Results
Butterly believes that the emphasis on teaching is critical to the success of the fairs, resulting in greater participation and correct use of the hemoccult tests. "When people leave the fair, we make sure they really know about screening and are comfortable with all aspects of it."
Butterly has begun to work with the Center for the Evaluative Clinical Sciences at Dartmouth Medical School to track and evaluate efficacy data on the fairs. "I think we can make suggestions to increase the efficacy of screening generally, based on our experiences and the information we are gathering," she says.
Under a grant from the Sherman-Fairchild Foundation, Butterly conducted six fairs in 2002-2003. She has six more planned for 2004, and hopes to find funding to continue the program in the future. "We want to improve how screening is done, not only in the communities that Norris Cotton Cancer Center serves, but generally across the country."
