Transcript Slide 1
Colorado Colorectal Screening Program
Holly Wolf University of Colorado School of Medicine [email protected]
303-724-1273
Colorful Colorado
Map of Colorado
Colorectal Cancer in Colorado
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Second leading cause of cancer death - Each year, 1690 diagnosed and 620 die
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Screening can reduce incidence (polyp removal)
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Screening can also reduce mortality
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FOBT by 30%
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Sigmoidoscopy by up to 50%
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Colonoscopy by up to 80%
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Only 55% Coloradans ages 50+ are screened
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66% ages 65 + (Medicare)
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52% ages 50-64 with health insurance
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26% ages 50-64 without health insurance
Colorectal cancer mortality, US and Colorado 30 25 20 15 10 5 0 White Non Latino Blacks Latinos United States Cancer Statistics: 1999–2002 www.cdc.gov/cancer/npcr/uscs.
US CO Asian
Total M ale 5-Year CRC survival CRC in Colorado
by proportion of neighborhood in poverty
ages under 65 ages 65 and older Non-Hispanic White Hispanic Black Localized Stage Regional Stage Distant Stage 0 20 20+% poverty 40 60 10-19% poverty 80 100 <10% poverty
CRC screening trends, US and Colorado
% 40 35 30 25 55 50 45 Non-Hispanic Whites Hispanics 1999 2002 2004
Colorado Colorectal Screening Program
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Funded by revenues from a tobacco tax
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Began in January 2006, expanded statewide in November 2006
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Partnership with community clinics
Approach
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Provide endoscopic colorectal screening to Coloradans without health insurance who are under 250% Federal Poverty Level and who need screening
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Encourage all Coloradans ages 50 and older to get screened.
Program Components
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Endoscopic screening in clinics or by referral
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Follow-up and Rx Patient navigation support Capacity development Public outreach & marketing Evaluation
Program Eligibility
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Coloradan ages 50 and older Under 50 if family or personal history Patient of a participating clinic Income below 250% of Federal Poverty No health insurance Need colorectal screening Lawfully present
Need for screening
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Assessed by primary care provider using consensus screening/surveillance guidelines
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Average risk – 50 years and older Increased risk
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under 50 Family history of colorectal cancer or adenomatous polyps Personal history of adenomas or colorectal cancer High risk – Under 50
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Family history of FAP or HNPCC Personal history of IBD for 8 years or longer
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Symptomatic 45 years or older
Findings from the first 925 CCSP colonoscopies
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65% female 47% Hispanic 8% African American
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99% had an adequate exam 21% had adenomas 1% had cancer
Goals
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Implement statewide screening asap
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Seamless program management
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Patient navigation and support
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Flexibility for new screening methods
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Screen approx 3000 per year
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Year 2010 objectives of 75% screening compliance among uninsured
Program information
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www.uccc.info/colonscreen
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CCSP coordinating center: 1-866-909-3481
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ACS help line: 1-866-227-7194
The Colorado Colorectal Screening Program Tim Byers, MD, MPH Angela Sauaia, MD Susan Rein, RN Andrea Dwyer BS Jan Lowery, PhD Holly Wolf, PhD