Seth Wiafe, PhD, MPH

Seth Wiafe, PhD, MPH, is director of health geoinformatics at Loma Linda University School of Public Health.

A Loma Linda University School of Public Health researcher is trying to find out why some U.S. military veterans are reluctant to use a popular test for colorectal cancer.

The fecal immunochemical test, or FIT, is faster and more convenient than the other colorectal screening test, the colonoscopy, yet is often shunned by veterans.

Unlike a colonoscopy, which must be administered by a physician while the patient is sedated, FIT involves no pain and does not require anything to be inserted into the patient’s anal opening while the patient is sedated. It is also far less expensive and can be self-administered at home.

Public health experts foresee a day when burgeoning demand will overtake the supply of gastroenterologists, making FIT the only sensible alternative.

Seth Wiafe, PhD, MPH, director of health geoinformatics at Loma Linda University School of Public Health, is analyzing data from more than 17,000 patients of the VA Loma Linda Healthcare System to find out why U.S. military veterans from some zip codes, but not others, are less likely to comply with their doctor’s orders to take the FIT.

Preliminary findings reveal zip code pockets within Inyo, Riverside and San Bernardino counties, where approximately half of veterans do not complete the test. Wiafe uses Tapestry Segmentation, a geographic information systems (GIS) developed by geomapping software firm Esri, to search for commonalities among zip codes where veterans do not support the test.

He says people should take colorectal cancer seriously and cites an American Cancer Society prediction that some 50,000 Americans will die from the disease this year. Wiafe notes that while colon cancer is the third most common cancer, it has the second-highest mortality rate of all cancers in this country. “Timely screening in adults can significantly reduce the incidence and mortality of colorectal cancer,” he says.

Wiafe is a pioneer in the use of GIS technology. A native of the West African country of Ghana, he hopes the data will yield a formula for predicting whether veterans of any given zip code are likely to take the test or not.

“If so, the Veterans Administration will need to find out how they can increase adherence in those areas,” Wiafe says.