ATLANTA, GA – U.S. government officials said on Thursday that they would start screening patients for unintentional weight loss and bloody stools, starting with Hartsfield-Jackson International (ATL) airport this coming weekend, in an effort to diagnose and contain colorectal cancer (CRC), one of the leading causes of cancer death worldwide.
The screenings are intended for travelers over the age of 50 with life expectancies greater than 10 years arriving from other domestic or international destinations, and will include a review of systems (ROS) and routine blood draw prior to deplaning. In the event of red flags such as unintentional weight loss, bloody stools, or iron-deficiency anemia, those travelers will be referred to a Transportation Security Administration (TSA) gastroenterologist for further evaluation.
Travelers are already familiar with Advanced Imaging Technology (AIT), a scanner that has been used over the past several years to screen passengers for weapons, explosives, or any other metallic or nonmetallic threats. AIT also has the ability to look for metallic and nonmetallic colorectal masses, including distant metastases. Other methods of evaluation include: pat-downs, rectal exams, fecal occult blood tests (FOBT), CT colonography (virtual colonoscopy), or endoscopic examinations (such as flexible sigmoidoscopy or traditional colonoscopy).
Airport colorectal screenings will not be conducted in private by default. However, travelers may request to have a private colorectal screening at any time. According to the TSA’s website, during such a private colorectal screening, another TSA officer will also be present and the passenger may be accompanied by a companion of his or her choosing. Depending on the findings, travelers may be asked to remain for overnight observation or even inpatient hospitalization.
Screenings will start taking place at 4 additional airports – Dulles International (IAD), John F. Kennedy International (JFK), Newark Liberty International (EWR), and O’Hare International (ORD) – early next week. According to federal officials and the American College of Physicians (ACP), 75% of travelers with an average-risk for developing colorectal cancer pass through these 5 airports.
Tomorrow, the American College of Gastroenterology (ACG) and the American College of Surgeons (ACS) will deploy gastroenterologists and general surgeons, respectively, at all 5 airports in order to help the TSA perform the airport colorectal screenings. The TSA is urging that all Americans remain patient during this process, especially when stool guaiac developer levels run low. If travelers have had a routine screening colonoscopy within the past year, they will be asked to provide a copy of the report with their plane ticket and photo identification. Over a 3-month time frame, the ACG and ACS hope to turn over all screening procedures to the TSA.
“We want to make sure we are thorough in protecting our citizens,” commented Dr. Ronald Everton, a member of the United States Preventive Services Task Force (USPSTF). “Healthy colons make for a better America.”
This represents the federal government’s first major attempt to improve cancer screening at American airports in a decade, a measure called for by many gastroenterologists, general surgeons, and oncologists nationwide with the increased number of patients succumbing to undiagnosed late-stage or metastatic colorectal cancer. The last cancer screening effort in American airports was in the early 2000s, when the TSA implemented endometrial sampling in post-menopausal female travelers with abnormal uterine bleeding.
Though the airport colorectal screenings present an additional hassle to an already cumbersome travel experience, many American travelers are understanding of the measure and plan to cooperate with the authorities, even if it means being on a clear liquid diet.
“It’s better than the government’s initial plan of banning travel altogether until every single American had a colonoscopy,” explained Delta Airlines pilot Timothy Jones, a 50-year old with a single benign polyp in the transverse colon removed earlier this year. “I applaud the government’s efforts. I think what they are asking of us now is reasonable.”
“This is about national security and personal health,” said Jonathan McCreary, a 55-year-old frequent flyer who has not yet had a routine screening colonoscopy. “It doesn’t sound like a bad process. Though being NPO after midnight seems kind of rough.”
By the winter of 2014, the federal government hopes all airports with the United States will be involved in the colorectal screening process.
In the spring of 2015, the TSA plans to offer a TSA Pre-Check program to expedite the screening process. Requirements will include filling out an online application and scheduling an appointment with a TSA Pre-Check primary care physician (PCP) for routine health screening.
Dr. Everton is optimistic and believes Americans will cooperate and make this a success.
“This is a huge step in the fight against colorectal cancer,” said Everton, while drinking his GoLYTELY. “Prevention doesn’t start with your primary care physician at home. It starts with your local airport before you even get home.”
