Z.I.A.D. Healthcare for the Underserved Inc. is a 501c3 Non Profit organization that came to be in 2002 when four individuals sat down and looked for ways to help provide access to the uninsured. Specifically they looked at those that fall through cracks, some 46,000,000 people in the United States. These are the people that work part time jobs (making them unqualified for governmental assistance), and receive no coverage from their employers, and cannot afford the premiums of health insurance.
Z.I.A.D. derives its name from the names of its founders Ray Zak, Iqbal Nasser MD, Ibraham Ahmed ND, Theodore Densley MD. Z.I.A.D. primarily works with private doctors to find a primary care home for the uninsured on a sliding scale program where they receive reduced office costs based on federal poverty guidelines.
If you are a primary care office and would like to participate in the program please call 313-815-8767.
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On August 9, 2022 Ray Zak the president of the board of ZIAD received a prestigious award from the Wayne County Health Authority for the work done by him in leadership of ZIAD Healthcare for the Underserved.
The plaque was awarded and titled “The Best Safety Net Award” with the following inscription:
“On The ninth day of August , 2022, in recognition for extraordinary commitment and service to community health care, we recognize Ray Zak.” The plaque was signed by Gail Warden and Chris Allen of the Wayne County Health Authority. Congratulations to Ray Zak on his devoted leadership of Z.I.A.D.
ZIAD Health Care for the Underserved participated in a health and community fair at Resurrection Lutheran Church Kelly Rd., Detroit, MI.. ZIAD provided the community with information on services that are available for the uninsured, and also provided Free Blood Pressure screening.The event was a cooperative program of three Lutheran churches in the Detroit area. Many residents turned out for the free information, screening, community togetherness, and some free hot dogs. Click here to see pictures from the event.
As always for information on health care call ZIAD at 313-815-8767
A Letter from the HeartDear Friends of ZIAD,
I have been blessed my entire life with the luxury of health insurance. My Father provided for me when I was a child, and I have been fortunate enough in my adult life to provide coverage for myself and my family. Recently, however, my son was stricken with a very rare blood disorder, and we were forced to live in a children’s hospital in Los Angeles for many weeks. I was able to see, first hand, how such a tragedy can financially ruin a family.
The bill for merely the first two weeks in the hospital came to just over $99,000 dollars. One bag of transfusable blood alone cost over $700 dollars. Our son faces a minimum of another 12 to 18 months of treatment. Without insurance, we would have been forced to declare bankruptcy, at the very least. There are thousands of families seeking care for loved ones with life-threatening and chronic afflictions every day. Sadly, the truth is there are many, many families that are turned away from facilities in this great country, only because they do not have enough medical insurance. Please help the gracious people of ZIAD provide care for the underinsured. If you have ever had a loved one need medical attention, you know the urgency of their mission.
Thank you, and may God bless your family with perfect health,
Paul Ganus
Nearly 46 million Americans, including more than 8 million children, are living without health insurance – forced to gamble every day that they won’t get sick or injured. That’s a risk no one should have to take. Uninsured Americans live sick and die younger than those with health insurance. Just one serious illness or injury can wipe out an uninsured family’s bank account, and the problem is getting worse.
To provide health care, health education, physical fitness and other programs to uninsured, under insured, poor, working poor families, and individuals. To provide access to health care in underserved areas, and to the frail elderly.
1) Expand the network of Private doctors offices, and services working with Z.I.A.D. Healthcare for the Underserved that provide primary healthcare as well as other services to underserved, poor, and working poor, and on a sliding scale basis to other geographical areas.
2) Expand services and assistance to the frail elderly.
3) To participate and collaborate with other organizations helping the uninsured or underinsured.
3) To participate and collaborate with Specialty, Pharmacy, Hospital, Dental and other programs to help the uninsured.
4) To identify, apply for and obtain grants that provide screening and outreach to identify disease early up.
Affiliates:
Donations: ZIAD Health Care for the Underserved Inc. is open to all donations public and private and has received Tax Exempt Status with the IRS (#75-3080830).
Donations can be made to ZIAD Health Care via PayPal. Below are buttons that you can use to donate now. We appreciate your donations very much.
For adults at average risk, colorectal cancer screening generally begins at age 45. Options include at-home stool tests, colonoscopy, CT colonography and flexible sigmoidoscopy. Colonoscopy is the most comprehensive single procedure because it can find and remove polyps, but it requires bowel preparation and usually sedation. Stool tests are easier to complete at home, but they must be repeated on schedule. Any abnormal non-colonoscopy result needs a follow-up colonoscopy—not another screening test—to complete the process.
The best screening test is usually the one a person can complete correctly and repeat at the recommended interval. The choice should also account for medical history, willingness to undergo preparation or sedation, access, insurance coverage and the likelihood of completing follow-up care.
The 2026 American Cancer Society guideline recommends regular screening beginning at age 45 for adults at average risk. The U.S. Preventive Services Task Force recommendation also covers average-risk adults ages 45 through 75, with selective screening from ages 76 through 85. For older adults, health, life expectancy, screening history and personal preferences become increasingly important. The American Cancer Society discourages screening after age 85.
These recommendations concern people without symptoms. Rectal bleeding, persistent changes in bowel habits, unexplained iron-deficiency anemia or other concerning symptoms call for diagnostic evaluation rather than routine screening. A personal or family history of colorectal cancer or certain polyps, inflammatory bowel disease, a hereditary cancer syndrome or previous abdominal or pelvic radiation can also change when and how screening should occur. Recording diagnoses and ages of onset in a useful family health history can help a clinician assess that risk more accurately.
| Option | Usual interval for average-risk screening | What it involves | Important tradeoff |
|---|---|---|---|
| FIT | Every year | One stool sample collected at home; generally no dietary or medication restrictions | Convenient, but must be repeated annually |
| High-sensitivity gFOBT | Every year | Multiple stool samples collected at home | Dietary or medication restrictions may apply |
| Multitarget stool DNA or stool RNA test | Every three years under the ACS guideline | At-home stool collection analyzed for molecular markers and blood | Less frequent than FIT, but an abnormal result still requires colonoscopy |
| Colonoscopy | Every 10 years | Bowel preparation followed by examination of the entire colon, usually with sedation or anesthesia | Can remove polyps during the procedure but is more invasive |
| CT colonography | Every five years | Bowel preparation followed by a CT-based examination; generally no sedation | Uses radiation and cannot remove a detected polyp |
| Flexible sigmoidoscopy | Every five years under the ACS guideline | Bowel preparation followed by examination of the rectum and lower colon | Does not examine the entire colon |
These intervals reflect options in the 2026 American Cancer Society guideline for average-risk adults. The USPSTF’s 2021 recommendation includes similar established options but also describes stool DNA-FIT every one to three years and flexible sigmoidoscopy every 10 years when combined with annual FIT. A clinician may recommend a different schedule when previous findings or individual risk factors change the situation.
Fecal immunochemical testing, or FIT, looks for human hemoglobin in stool. It generally requires one sample and does not require the dietary or medication restrictions associated with high-sensitivity guaiac fecal occult blood testing, or gFOBT. Low-sensitivity gFOBT is not recommended.
Multitarget stool tests combine blood detection with molecular markers. The ACS guideline lists stool DNA and, as of its 2026 update, multitarget stool RNA testing at three-year intervals. Stool-based screening avoids bowel preparation and can be completed at home, but convenience does not eliminate the need for consistency: a test due annually only works as an annual strategy when it is actually repeated.
Colonoscopy examines the full colon with a flexible instrument. It can also allow a clinician to biopsy abnormal tissue or remove polyps during the same procedure, making it both a detection and prevention tool. Preparation requires clearing the bowel, and the procedure is commonly performed with sedation or anesthesia. Bleeding and perforation are uncommon but possible, particularly when tissue is removed, and procedural risks increase with age.
For an average-risk person with a normal result, the usual screening interval is 10 years. That long interval is an advantage, but practical issues—preparation, transportation after sedation, time away from work and access to an endoscopy facility—may influence whether it is the most workable first choice.
CT colonography uses imaging to examine the colon. It still requires bowel preparation, but it generally does not require sedation. It uses radiation and may reveal findings outside the colon that lead to additional evaluation. Flexible sigmoidoscopy uses an instrument to inspect the rectum and lower portion of the colon, rather than the entire organ, and also requires preparation.
Neither test can remove a polyp during the screening exam. If either identifies a concerning finding, colonoscopy is needed for further evaluation and possible removal.
The FDA approved the Shield blood test in July 2024 for colorectal cancer screening in average-risk adults age 45 or older. A positive result should be followed by colonoscopy. The FDA states that the test is not a replacement for diagnostic colonoscopy or surveillance colonoscopy in people at higher risk. FDA information about the Shield blood test provides the approved-use details.
The ACS does not currently classify blood-based screening as a preferred option. Its 2026 guideline says blood tests should be offered to people who decline or do not complete preferred stool-based or structural options, citing lower sensitivity for advanced precancerous lesions and stage I cancers. In practical terms, a blood test may be preferable to no screening, but it should not automatically be treated as equivalent to established preferred methods.
An abnormal stool test, CT colonography or flexible sigmoidoscopy result requires a follow-up colonoscopy to complete the screening process. The ACS says that follow-up should preferably occur within six months. Repeating a positive stool or blood test is not an appropriate substitute for diagnostic follow-up.
Cost questions are worth resolving before choosing a test. Federal guidance says that for many non-grandfathered private health plans, follow-up colonoscopy after a positive stool-based or direct-visualization screening test is part of preventive screening and must be covered without cost-sharing for people in the USPSTF-recommended population. Individual circumstances still vary. Medicare recognizes several colorectal screening services, including colonoscopy, CT colonography, flexible sigmoidoscopy, fecal occult blood testing and qualifying noninvasive biomarker tests.
Start with three practical questions: Which test can you complete now? Will you repeat it on schedule? If it is abnormal, can you complete colonoscopy promptly? A test with a convenient collection method but poor follow-through is not a complete screening strategy.
No screening result guarantees that cancer is absent; false-negative and false-positive results can occur. The practical goal is therefore not to find a flawless test. It is to choose an evidence-supported pathway, complete it at the right interval and follow through when a result requires further evaluation.
Not for everyone. Colonoscopy examines the entire colon and permits polyp removal, but an at-home test may be easier for some people to complete. The best strategy is one appropriate for the person’s risk level that can be completed and repeated reliably.
No. A positive stool-based screening result calls for follow-up colonoscopy. Repeating the stool test can delay the diagnostic evaluation needed to understand the original result.
No. Screening tests can produce false-negative results. A negative result means the recommended screening interval continues; it does not mean symptoms should be ignored.
Sometimes. From ages 76 through 85, the decision is individualized according to health, life expectancy, prior screening and preferences. The ACS discourages screening after age 85.