Since March, most routine health screenings have been delayed because of the COVID-19 pandemic. Providence Community Health Centers (PCHC) is creatively addressing the need for colorectal cancer screening with tests that are mailed to the patient’s home, completed, and returned by mail to be tested in a laboratory.

The fecal immunochemical test (FIT) is an inexpensive, at-home colorectal cancer screening method that checks for traces of blood and proteins in the patient’s stool that cannot be seen by the naked eye. Patients with suspicious test results are scheduled for a follow-up colonoscopy. About 1 out of 7 FIT tests results are abnormal, but an abnormal FIT test does not mean cancer is present, only that a colonoscopy is necessary to find out why there was microscopic blood in the stool. The first tests were mailed out by PCHC earlier this month, with a total of 3,700 patients currently in need of screening this year. Learn more about the tests here: https://www.providencechc.org/colorectal-cancer/

PCHC utilized data from its Electronic Medical Record to identify patients who needed screening and did not have a test ordered or had not completed a previously-scheduled test. While FIT is not as accurate as a traditional colonoscopy, it allows for effective screening in remote health care settings, making it very useful during times of mandated social distancing. FIT testing, in addition to being more acceptable to many patients, also frees up limited colonoscopy appointments for patients likely to need them, and the FIT test can be completed in the privacy of patients home – without taking a day off work or childcare and finding a responsible adult to escort you after the anesthesia used during a colonoscopy.

“At a time when most routine health screenings have been delayed, FIT screening is a valuable tool that allows us to continue screening at-risk populations for colorectal cancer,” said Dr. Jonathan Gates, Chief Medical Officer for Accountable Care at PCHC. “Despite the COVID-19 pandemic, we must continue to find creative ways to advocate for disease prevention and detection. FIT testing is preferred by many patients who would not otherwise accept the more invasive colonoscopic screening.”

The process in completing a FIT test is a simple one. A kit including a small stick and bottle are mailed to the patient’s home. The patient uses the stick to obtain a small stool sample, which they place in the bottle. That sample is then mailed back to PCHC’s electronically interfaced lab, East Side Clinical Laboratory in most cases. The test is then conducted in a laboratory with technicians searching for small amounts of blood in the stool that are often undetectable with the human eye.

FIT tests are only good for a year by U.S. Preventive Services Task Force guidelines; by contrast, a colonoscopy – if totally normal – is good for 10 years.  But a one year reprieve from colonoscopy in today’s world can make all the difference, using our limited colonoscopy appointments on the patients most likely to have abnormalities or colorectal cancer.

FIT testing isn’t for everyone – patients with a family history of early colorectal cancer, those who have had irradiation to the abdomen, and those with past abnormal colonoscopies or known inflammatory bowel disease such as Crohn’s disease or Ulcerative Colitis are not candidates for FIT Testing. Patients with hereditary genetic predispositions to colon cancer (HNPCC and Familial Adenoma Polyposis are two) also require colonoscopy as the only test.

Still, FIT testing is a useful tool in diagnosing colorectal cancer, which is the second-highest cause of cancer deaths in the United States. It is estimated that nearly 23 million adults aged 50 to 75 are past due for screening, and an estimated 53,000 Americans will die from colorectal cancer this year.

Merrill Thomas, President and CEO of The Providence Community Health Centers (PCHC), has been recognized as a “2020 Leaders & Achievers” awardee by the Providence Business News.

The 25 individuals recognized were chosen based on their leadership, achievements, and longstanding commitment to the business community, as well as a sustained demonstration of leading others, community service, and mentoring in the region. The executives honored in this year’s program work in various industries and sectors, including health care, government, nonprofit, real estate, finance, and manufacturing.

Next year will mark 20 years since Thomas was named President and CEO of PCHC. During that time, he has worked with an outstanding group of clinicians, support staff, leaders, and the Board of Directors to double the number of patients served. Last year, PCHC provided care to more than 60,000 Rhode Islanders, its highest total ever.

During Thomas’s time at the helm of PCHC, the organization has launched numerous new sites and programs with a goal of best serving the community. PCHC’s operating budget has grown from $7 million to $70 million during that time and the staff has grown to more than 540.

The honorees will be recognized at a virtual awards ceremony on August 20th.

AUGUST 13, 2019

Claudia Clarke, DO, Internal Medicine-Pediatrics – PCHC Central
Dr. Clarke earned her Bachelor’s degree in Biopsychology and Biomedical Engineering Systems from Tufts University; her Doctor of Osteopathic Medicine from Rowan University School of Osteopathic Medicine. After completing her Internal Medicine and Pediatrics residency training at the State University of New York - University at Buffalo, Dr. Clarke cared for patients at an inner city community health center near Boston, MA. She is committed to caring for both children and adults. Her clinical interests include Osteopathic Manipulative Treatment (OMT) and caring for adult survivors of childhood diseases. Claudia is first-generation Jamaican-American and is bilingual, English and Spanish. In her free time, Dr. Clarke enjoys bird watching, kayaking and snowshoeing.

Sheldon Malcolm, DO, Family Medicine – PCHC Prairie
Dr. Malcolm received his Bachelor’s degree from Bates College and is a graduate of University of New England College of Osteopathic. He completed his family medicine residency at Memorial Hospital of Rhode Island/Brown Family Medicine Residency. He was most recently practicing in North Providence and looks forward to meeting his new patients at PCHC Prairie Avenue. When Sheldon is not working, he enjoys gardening, yoga and spending time with his family. Sheldon is joining PCHC this summer, replacing Dr. Cesar Mora who is moving to PCHC Express.

Zein Farhat, MD, Family Medicine – PCHC Chafee
Dr. Farhat earned his Bachelor of Sciences degree from the American University of Beirut in Lebanon; and his medical degree from University of Balamand, School of Medicine in Lebanon. Dr. Farhat completed his Family and Community Medicine Residency program at the University of Maryland Medical Center in Baltimore, Maryland where he is Chief Resident and a member of the Family Medicine Residency Educational committee. Prior to his residency, Dr. Farhat completed a Public Health Fellowship at the department of Pharmaceutical Health Services Research with the University of Maryland, School of Pharmacy. In his free time, Zein enjoys traveling, swimming and playing soccer. He has relocated to Rhode Island with his wife and their one-year-old son.

Ekknoor Sahota, MD, Internal Medicine – PCHC Olneyville 
Dr. Sahota received her Bachelor of Medicine, Bachelor of Surgery from Dayanand Medical College and Hospital in India, and completed her residency in Internal Medicine with Allegheny General Hospital in Pittsburgh, Pennsylvania. Dr. Sahota also completed a fellowship in Patient Safety and Quality Improvement in Pittsburgh. Ekknoor was raised in India, moved to Canada and then to Pennsylvania. She recently relocated to Rhode Island. Dr. Sahota is fluent in English, Hindi and Punjabi. In her free time, Ekknoor enjoys biking, hiking and other outdoor activities. Dr. Sahota will be serving Dr. Erick Soria-Galvarro’s patients as Dr. Soria is moving to a Float provider position with PCHC while his family prepares to leave Rhode Island.

Ursulina Bencosme, MD, MPH, Pediatrician – PCHC Central
Dr. Bencosme earned her Bachelor’s degree in Chemistry from St. Joseph’s College; her Doctor of Medicine from Cornell University Medical College; and her Master of Public Health from Columbia University Mailman School of Public Health. Dr. Bencosme completed her Pediatric residency with Brown University at Hasbro Children’s Hospital in Providence and is excited to be moving back to Rhode Island. Dr. Bencosme has nearly 20 years of experience providing primary care to children and adolescents. As both a Pediatrician and Assistant Medical Director of Children’s Aid in New York, Dr. Bencosme has also had significant involvement implementing programs and trainings in foster care health. In her free time, Ursulina enjoys traveling, cooking and spending time with her husband, son and daughter. She is bilingual English/Spanish. Dr. Bencosme will be caring for Dr. Ellen Gurney’s patients when Dr. Gurney retires at the end of the summer.

Please join us in welcoming everyone to PCHC.

On June 21st, PCHC received a Providence Business News Best Places to Work in Rhode Island Award for the second year in a row! It was a tremendous event, with many outstanding businesses coming from all over Rhode Island. Thank you to those staff members who attended the event, as well as to all our exceptional staff members who made this award possible; we are very proud!

For a list of all of the companies awarded, please visit the Providence Business News (PBN) website https://pbn.com/event/best-places-to-work/