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“I Owe My Life to the Test”

Kaiser Permanente Northern California’s award-winning, evidence-based screening program finds colon cancer soon after member Antonio Jofre’s 50th birthday.

When Antonio Jofre walked into the Kaiser Permanente Walnut Creek Medical Center in October 2016, he thought he was merely getting a flu shot.

“The nurse who was giving the flu-shots noticed that I had just turned 50, so she offered me the FIT test to screen for colon cancer. She said it would be easy to do at home,” explained Jofre, of Clayton, California, who is now 52. “The FIT test was positive for blood in my stool, and I had to go in for a colonoscopy.”

Jofre was quickly referred to Walnut Creek gastroenterologist Theodore (TR) Levin, MD, a research scientist with the Division of Research.

“Within a couple of seconds of starting his procedure, there was a cancer right in the lower part of his colon,” said Dr. Levin, who has served as clinical lead of colorectal cancer screening for Kaiser Permanente Northern California since 2004.

Award-winning Program


According to the American Cancer Society, colorectal cancer is the third-leading cause of cancer deaths in the United States. But with screening, precancerous polyps can be found early and removed from the colon, thereby preventing the disease or making it easier to treat.

DOR’s TR Levin, clinical Kaiser Permanente lead for colorectal cancer in Northern California, accepted a national award from Juliane Lee of the American Cancer Society

This March, coinciding with Colon Cancer Awareness Month, Kaiser Permanente Northern California received the National Colorectal Cancer Roundtable’s prestigious “80% by 2018” National Achievement Award, in recognition of screening rates over 83 percent for colorectal cancer. In addition, Kaiser Permanente Northern California has achieved a 90 percent screening rate among its Medicare members, the third-highest among Medicare plans in the nation.

“The Kaiser Permanente FIT-based outreach program, combined with colonoscopy, has become a model for similar programs to maximize the number of people screened in the United States and internationally,” said Richard Wender, MD, chief cancer control officer for the American Cancer Society and roundtable chair.

Led by Dr. Levin, the region’s colorectal cancer screening team mails upward of 20,000 FIT kits to eligible members across the region every week, and a Kaiser Permanente laboratory in the East Bay processes about 3,000 mailed-in stool tests daily.

Kaiser Permanente follows recommendations of the U.S. Preventive Services Task Force to screen average-risk adults between ages 50 and 75 with a colonoscopy every 10 years or an annual at-home FIT test.

Screening Saves Lives

Recent research by Dr. Levin and Division of Research colleague Douglas A. Corley showed that since this aggressive screening program began, cases of colorectal cancer declined by 26 percent among Kaiser Permanente members in Northern California, and deaths declined 52 percent.

TPMG gastroenterology chiefs celebrated the National Colorectal Cancer Roundtable Award with a cake.

“The most gratifying aspect of this work is the knowledge that there are parents and grandparents spending time with their families who wouldn’t have otherwise, because the physicians and staff of Kaiser Permanente Northern California did the hard work of improving our screening performance,” Dr. Levin said.

“I’m Living a Normal Life”

When Jofre mailed in his FIT kit, he joined more than 830,000 Kaiser Permanente members in Northern California who are up to date with colorectal cancer screening.

Within weeks of his flu shot, Jofre’s colon cancer was surgically removed and he underwent chemotherapy.

After finishing treatment, he returned to work in his auto repair shop in Walnut Creek, California. “Thanks to the FIT test, I’m doing great. I’m living a normal life, and I’m going to be able to grow old with my wife and see my children grow,” Jofre said.

“I owe my life to the test.”

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