Kentucky Colon Cancer Screening Program

(KRS 215.540-215.544) PHN ITV

April 18, 2013

Connie Gayle White, MD, MS, FACOG

Deputy Commissioner, KDPH Division Director, DPQI

Why have a screening program?

* Colon Cancer is the third most common cancer diagnosed in both men and women in the US * Colon Cancer is the second leading cause of cancer death in men in Kentucky * Colon Cancer is the third leading cause of cancer death in women in Kentucky * Colon Cancer is >90% preventable if precancerous polyps are removed

US Rate: 46.30

US Rate: 16.70

Colon Cancer Screening Advisory Committee

(KRS 214.544)

Agency Representative Agency Representative J. Mel Bennett, MD Chair American Cancer Society Colon Cancer Prevention Project Colon Cancer Prevention Project Colon Cancer Prevention Project Kentucky African Americans Against Cancer Kentucky Cancer Consortium Kentucky Cancer Program Ellen Schroeder William Beam Whitney Jones, MD Andrea Shepherd Virginia Bradford, RN Jennifer Redmond, DrPH Debra Armstrong, MSW, MPA VA Medical Center Kentucky Department for Public Health Kentucky Hospital Association Kentucky House of Representatives Kentucky House of Representatives Kentucky Senate Kinkead & Stilz, PLLC Connie Gayle White, MD, MS Kim Dees Rep. Rocky Adkins Rep. Tom Burch Sen. Alice Forgy Kerr Benjamin Kessinger, III Kentucky Cancer Program Kentucky Cancer Registry Kentucky Department for Medicaid Services Connie Sorrel Tom Tucker, PhD, MPH Pike County Health Department UK Markey Cancer Center Paul Hopkins Mark Evers, MD Mary Coleman, RN UL Brown Cancer Center Donald Miller, MD, PhD

Colorectal Cancer Screening in Kentucky

70% 63.7% 63.7% 58.6% 60% 50% 43.9% 47.2% 40% 34.7% 30% 1999 49 th in the U.S. 2002 2004 2006 2008 2010 20 th in the U.S.

Funding:

* KRS 215.540-215.544

* Legislature assigned $1 million this biennium (FY 13 – FY 14) * This money will be matched (another $1 million) by the Kentucky Cancer Foundation, a private organization * 10 sites received funding for this project

Program Objectives

 Target Population: Low income uninsured adults aged 50 to 64  Increase colon cancer screening  Reduce morbidity and mortality from colon cancer  Reduce the cost of treating colon cancer through screening and early detection  Screening Services (annual)  1,500 FIT Screenings  150 Colonoscopies following a positive FIT  500 Colonoscopies for those at increased risk for CRC

Program Objectives

 Target Population: Low income uninsured adults aged 50 to 64  Increase colon cancer screening  Reduce morbidity and mortality from colon cancer  Reduce the cost of treating colon cancer through screening and early detection  Screening Services (annual)  1,500 FIT Screenings + 1,500 FIT screens donated by Metro LOU  150 Colonoscopies following a positive FIT  500 Colonoscopies for those at increased risk for CRC  Plus 150 Colonoscopies donated by Metro LOU

Tasks Accomplished to Launch the Program

 Development and Release of RFP Review and Scoring of proposals      Development of program policies, manual, and forms Contracted for lease of FIT analyzer Programming of state lab data system for data collection Provided 6 face to face trainings for patient navigators 10 initial site visits conducted – visits continue throughout the grant period

10 Funded CRC Screening Sites * Note – Counties of the same color are funded as one site ** Counties with a starburst are the fiscal agent for multiple counties not part of a health department district

Counties Funded for the Kentucky Colon Cancer Screening Program: 2012-2014

10 Funded CRC Screening Sites Plus Counties with Coal Severance Funds

Counties Funded for the Kentucky Colon Cancer Screening Program: 2012 - 2014 Counties Receiving Coal Severance Funds

Positive FIT screening or High risk by history

Positive FIT screening would lead to colonoscopy or High risk by history

Outcome and Quality Control Reports

 # and % Positive FIT  # and % Defined as Increased or High Risk  # and % Positive Scope  Complications on Scope  Cecum Reached and Entered – Target 95%  Quality of Prep – Target 90% Good or Excellent     # and % with Polyps # and % with 1cm or larger polyps  # and % needing surgical resection # and % lost to follow-up Documentation of connection to cancer treatment  % with Positive FIT where colonoscopy occurs within 90 days – Target 95%

Data of colonoscopy results: first 2 months

● 25 colonoscopies ages 30 to 64 ● 7 with family history of colon cancer ● 3 with personal history of colon polyp removal ● 14 negative colonoscopies ● 9 polyps – 5 adenomatous polyps ● 1 cancer

April 9, 2013

Thank you to all the partners who have made this program possible!

Kentucky Cancer Registry Kentucky Cancer Foundation Kentucky Department for Public Health Kentucky General Assembly Local Health Departments Kentucky Colon Cancer Screening Program Advisory Committee Kentucky Cancer Program Community Health Care Providers

Colon cancer awareness

IT’S NOT JUST FOR MARCH ANYMORE

Kentucky Department for Public Health Staff

  Stephanie Mayfield Gibson, MD – Commissioner  Director, Division of Kentucky State Laboratory Connie Gayle White, MD, MS – Deputy Commissioner  Director, Division of Prevention and Quality Improvement  Gary L. Kupchinsky, MA - Assistant Director  Sue Thomas-Cox, RN, BA, MAC – Branch Manager Chronic Disease Prevention * Janet Luttrell – Colon Cancer Program Coordinator  Becki Thompson, RN, BSN, CDE - Nurse Consultant  Teri Wood, PhD - Epidemiologist, Data Management and Outcome Reporting