Reducing cancer deaths, one test at a time

Douglas A. Corley, MD, PhD 

I think I can speak for most physicians in saying that one of the most frustrating situations we face is late diagnosis of a serious condition. It’s a heartbreak many of us know too well — and one we have the power to prevent. 

At Kaiser Permanente of Northern California, we’ve proven what’s possible when prevention becomes a systemwide priority. By building an integrated, patient-centered colorectal cancer screening program, we doubled screening rates, cut deaths by 50%, and made major strides in closing racial disparities in outcomes. 

Why colorectal cancer screening matters more than ever

Colorectal cancer screening is one of the most treatable cancers when detected early — yet it remains the second leading cause of cancer death in the United States. A third of U.S. adults are not up to date with their screenings, and we are now seeing sharp increases in colorectal cancer among young people, making new approaches to timely, convenient screening even more urgent. 

To improve early diagnosis and drive better outcomes, Kaiser Permanente launched a powerful, integrated screening program that has saved thousands of lives. The approach was simple: consistently alert patients that it’s time to get screened and make getting screened as easy as possible. When a patient visits any physician for any reason, they are reminded that it is time for their screening, flagged by our integrated electronic health record. Members who are not up-to-date with screenings or have not met with their physician recently are mailed a fecal immunochemical testing (FIT) kit they can complete at home, removing the need for time away from work, sedation, or an in-person appointment. 

This convenience addresses the biggest barriers patients face, particularly in communities historically underserved by preventive care and for those who have less contact with health care. 

Behind the numbers: 50% drop in deaths

A recent Kaiser Permanente study, presented at Digestive Disease Week 2025, captures the tremendous impact of Kaiser Permanente’s colorectal cancer screening program, analyzing data from 1.1 million men and women between the ages of 50 and 75, over nearly two decades. 

What we found is truly impressive: 

• Screening rates among our Northern California patients nearly doubled — from 37.4% in 2000 to 79.8% in 2019 

• Deaths from colorectal cancer decreased by 50% overall 

• One of the largest reductions was among Black patients, with mortality rates dropping from 52.5 per 100,000 in 2009 to 23.5 per 100,000 in 2019 

• By 2019, mortality rates for white, Hispanic, and Asian patients decreased to about 20 per 100,000 

These findings are significant, as Black people in the United States are 20% more likely to get colorectal cancer and 40% more likely to die from the disease than other groups. By the end of the study period, racial disparities in colorectal cancer screening and outcomes were largely eliminated, just by simplifying screening for the disease.  

Related cancer care story: Improving cancer care through expert virtual reviews 

What physician leaders can learn from this approach

The success of this program makes a compelling case for rethinking how we deliver preventive care. A simple, effective approach that meets patients where they are, simplifies access, and makes prevention a routine part of care that saves lives. 

Programs like this can be implemented by physician leaders in a range of health care settings. Elements of Kaiser Permanente’s valued-based and integrated care model, like a commitment to innovation and access to technology, aided in deploying these strategies. But at its core, this program is about communicating with patients and understanding their needs. With these insights, physician leaders can implement a comprehensive and life-saving screening program that’s tailored to any community. 

The results we’ve seen reaffirm the importance of prevention-first care models — and show what’s possible when we turn evidence-based approaches into action. 

Douglas A. Corley, MD, PhD, is chief research officer at The Permanente Medical Group and a research scientist at the Kaiser Permanente Northern California Division of Research.