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Dr. Muhammad Alsayid Publishes MPH Practicum Research on Using Fecal Immunochemical Test for Colorectal Cancer Screening

Dr. Muhammad Alsayid Publishes MPH Practicum Research on Using Fecal Immunochemical Test for Colorectal Cancer Screening

UW Online Executive MPH Program alumnus Muhammad Alsayid, MD, MPH has first-authored a new article on the performance of an FDA-cleared fecal immunochemical test (FIT) for colorectal cancer (CRC) screening, published in Clinical Gastroenterology and Hepatology in April 2018. The project grew out of Muhammad’s MPH practicum project with the University of California San Francisco (UCSF) Division of Gastroenterology, where he worked under the supervision of Dr. Ma Somsouk.

Muhammad’s practicum project focused on CRC screening in the San Francisco safety-net health network. San Francisco Health Network (SFHN) provides a wide variety of health care services to uninsured, Medicaid, and other vulnerable populations. The CRC screening program mails FIT kits to local people aged 50–75, and completed tests are mailed back to a central laboratory at the Zuckerberg San Francisco General Hospital.

For this study, Muhammad performed a retrospective cohort study of nearly 21,000 patients in the SFHN who were screened for CRC by OC-Light FIT from 2010-2015. Patients with a positive result were referred for colonoscopy. The team used electronic health records to identify participants with positive FIT results (2,930 patients; 8.3%) and collected results from subsequent colonoscopies and pathology analyses. Of patients with positive results from FIT, 53% underwent colonoscopy. The yield of colonoscopy following positive results from FIT for CRC was 3.0% and approximately 21% for advanced adenoma. The FIT positive rate was higher during the first round of testing (9.4%) compared to subsequent rounds (7.4%) (P<.01). The yield of CRC in patients with a positive result from the first round of the FIT was 3.7% and decreased to 1.8% for subsequent rounds (P=.02). 

Muhammad explains, “Our team at UCSF studied the performance of OC-Light FIT in a large diverse population. These results demonstrate that OC-Light FIT is an effective method to identify individuals at high risk for colorectal cancer. The results of our study emphasize the importance of performing colonoscopy for people with positive results from FIT, and show that using FIT as a screening tool in safety-net health systems can effectively allocate colonoscopy procedures. FIT can identify one case of CRC in 33 colonoscopies, instead of one CRC case in approximately 200 colonoscopies (without using FIT).”

“FIT technology has the potential to save lives,” Muhammad stresses, adding that “colorectal cancer is the second leading cause of cancer-related deaths in the US. In 2018, it is expected that around 140,000 people will be diagnosed with CRC and more than 50,000 people will die from it. CRC is a preventable disease, and is curable in the early stages. For these reasons, people who are 50 years or older should undergo screening for CRC. There are different methods of CRC screening, including stool-based tests like FIT and colonoscopy. Positive results from FIT should be followed by colonoscopy to detect advanced adenomas and CRC.”

Reflecting on his academic and professional journey, Muhammad recalls, “My passion for gastroenterology began during my clinical rotation in the Gastroenterology Department at the University of Texas Medical Branch in Galveston. I was fascinated by the wide variety of diseases in the gastrointestinal tract, and the capability of endoscopy procedures to diagnose and treat patients. During my MPH training at the University of Washington School of Public Health, I studied the consequences of healthcare disparities and the importance of providing healthcare to vulnerable populations, and this inspired me to join the CRC screening program at the UCSF.”

“Multiple courses in the Online Executive MPH program helped prepare me for my work on this study, which included performing a literature review, conducting data analysis, and writing the manuscript,” says Muhammad. “I am particularly grateful for the Epidemiology and Biostatistics classes I took, where I gained the skills of study design and data analysis using STATA. My coursework in ethics and quantitative research methods were also very helpful for this study.”

Muhammad adds, “I also want to express my gratitude to my site supervisor, Dr. Ma Samsouk, to my study team members, and to the multiple gastroenterology leaders who provided extensive review of the study.”

After graduating, Muhammad joined the University of Massachusetts Medical Center as an Assistant Professor of Medicine in the Gastroenterology Division. He is currently involved in several studies on racial disparities in colorectal cancer screening, chronic pancreatitis, and video capsule endoscopy. Muhammad’s long-term goal is to become an academic gastroenterologist with a focus on healthcare disparities and colon cancer prevention.

To learn more about Muhammad’s work, check out his publication:

Alsayid M, Singh MH, Issaka R, Laleau V, Day L, Lee J, Allison J, Somsouk M, Yield of Colonoscopy After a Positive Result From a Fecal Immunochemical Test OC-Light, Clinical Gastroenterology and Hepatology (2018), doi: 10.1016/j.cgh.2018.04.014

Congratulations, Muhammad!