App to improve colorectal cancer screening

By Sharon Henry


Dr. William Karnes discusses colorectal cancer screening failings at SURF-IoT seminar



 Irvine, August 20, 2015— Dr. William Karnes, a gastroenterologist with a primary interest in colorectal cancer prevention, spoke at this year’s final SURF-IoT seminar this week at Calit2.

“One in 20 people will be diagnosed with colon cancer in their lifetime. And two-thirds of those diagnosed have no family history of colon cancer,” Karnes told the audience of SURF-IoT Fellows and guests.

Most forms of colorectal cancer are slow-growing. A 10-year window of opportunity exists, when colorectal cancer can be prevented by finding and removing colorectal polyps before the cancer spreads to other areas in the body.

Colonoscopy, a procedure that uses a thin, flexible tube to allow a physician to look at the inner lining of a patient’s large intestine, is considered the gold-standard in colorectal cancer screening; it is the best test for finding precancerous polyps and the only test that can remove them.  Seventy to 90 percent of colorectal cancers are preventable by finding and removing precancerous polyps, because when a polyp is removed it never has the chance to turn into cancer, Karnes said.

Karnes is currently working with UCI Associate Professor of Informatics Donald Patterson to develop Qualoscopy, a web-based application to help gastroenterologists collect, monitor, and measure quality indicators associated with colonoscopy. SURF-IoT Fellow and computer science major Luke Raus is assisting with developing the app’s interface.

The Qualoscopy app is designed to allow doctors to gather and record data on quality indicators for each colonoscopy as it is administered in real-time. 

Karnes imagines a day when performance data from the application will be public knowledge. Patients seeking information for their own procedure would have access to critical information to help make a more informed decision when selecting a doctor for their colorectal cancer screening.

Even with the use of colonoscopies, about nine percent of colorectal cancers occur in patients who are up-to-date with their screenings. Of these cases, about 80 percent are attributed to a failure of colonoscopists to find and completely remove polyps.

In a typical career, a colonoscopist can expect to prevent 880 people from getting colorectal cancer. “But, we will fail to prevent 120 colorectal cancers,” he said. It’s this failure of the colonoscopist that Karnes is working to change.

Quality colonoscopy also has become a major emphasis of Medicare's new quality measures program. Colonoscopists are now required to report several quality indicators with associated benchmarks that will determine their level of Medicare reimbursement, according to Karnes.

Quality indicators and benchmarks include bowel prep quality – ensuring a patient’s large intestine is clear enough for the colonoscopist to thoroughly inspect the surface of the organ –  adequate time (more than six minutes) to search for polyps during withdrawal of colonoscopy instrument, and number of pre-cancerous polyps detected and removed.

With the app, users will be able to utilize this data to track their own performance, and submit the real-time reports to Medicare to apply for payment.

UCI’s 10-week SURF-IoT program concludes Thursday, August 27, with a final symposium at which students will present their research results.