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GASTROENTEROLOGY
Raising CRC awareness through humor & levity: 3
Qs with Dr. Charles Friel
By Rachel Popa
C
harles Friel, MD, colon and rectal
surgery chief at the Charlottesville-
based University of Virginia Medical
Center, dressed up as a red colon polyp
named Paulie to educate staff and patients
about colon cancer prevention.
Dr. Friel spoke with Becker's ASC Review
about his inspiration for the costume, and
the importance of CRC screenings.
Note: Responses have been edited for style
and clarity.
Question: What was the inspiration
for Paulie the Polyp, and why did
you volunteer to represent him?
Dr. Charles Friel: It started about 10 years
ago when I first played the role in our Dog-
wood parade. Colon cancer and screening
is an awkward topic to discuss so by adding
some levity and humor, it allows people to
engage in conversation and, I hope, ulti-
mately get the important message out that
there is something we can do to help prevent
colon cancer. e costume is a bit extreme,
but it does make people remember!
Q: What is your view on the Ameri-
can Cancer Society lowering the
screening age to 45?
CF: ere is no doubt that, while overall the
incidence of colon cancer has been decreas-
ing for many years, the incidence in young
people has actually increased. We believe
screening has helped in the older population,
so now that we have identified young people
as being at increased risk, our hope is that by
decreasing the age, we can positively impact
outcomes in our younger patients as well.
It is critical to understand that screening
implies no symptoms. Once you have symp-
toms, even if you are below 45, this needs to
be evaluated thoroughly by your doctor since
it could be a sign of colon cancer.
Q: Is there something you're
proud of that you or your hospital
achieved during colorectal cancer
awareness month?
CF: We continue to push the message that
screening is effective. We cannot under-
estimate the importance of education and
getting the word out. If it takes a little bit of
public humiliation on my part by donning
the costume of Paulie the Polyp, then it is
all worth it. n
Early-onset CRC rates continue to rise
By Eric Oliver
E
arly-onset colorectal cancer incidence rates increased in several high-
income countries, according to research published in The Lancet Gastro-
enterology & Hepatology.
While CRC incidence rates in recommended screening populations continue
to fall, spiking early-onset CRC rates are concerning. Researchers looked at 10-
year colon and rectal cancer incidence rates in 21 population-based registries
for people aged zero to 49 years.
From 2004 to 2014, early-onset colon cancer rates increased in Denmark by
3.1 percent, New Zealand by 2.9 percent, Australia by 2.9 percent and the U.K.
by 1.8 percent.
Early-onset rectal cancer rates increased in Canada by 3.4 percent, Australia
by 2.6 percent and the U.K. by 1.4 percent during the same time period.
Increases in the 20 to 29-year age group were most concerning. Rectal cancer
rates increased 18.1 percent in Denmark and 10.6 percent in Norway during
the same time period.
In recommended screening populations — above 50 years old — colon cancer
rates decreased in New Zealand by 3.4 percent, in Canada by 1.9 percent and
in Australia by 1.6 percent. Rectal cancer rates also decreased in Australia by
2.4 percent, in Canada by 1.2 percent and in the U.K. by 1.2 percent during
the same time period. n
3 ASCs, endoscopy
centers with the
highest colonoscopy
volume in 2018
By Rachel Popa
P
rivate and government insurers
received claims for colonosco-
py procedures from 2,250-plus
ASCs in 2018, according to Definitive
Healthcare data.
The three ASCs and endoscopy
centers with the highest volume of
colonoscopies:
1. Springfield (Ill.) Clinic Ambulatory
Surgery Center: 17,214 colonoscopy
claims
2. Barkley Surgicenter (Fort Myers,
Fla.): 16,604 colonoscopy claims
3. The Endoscopy Center (Miami):
13,627 colonoscopy claims n
