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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
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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
Colorectal Cancer Screening in Kentucky 70% 63.7% 63.7% 58.6% 60% 47.2% 50% 43.9% 40% 34.7% 30% 49th in the U.S. 20th in the U.S. 1999 2002 2004 2006 2008 2010
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
10 Funded CRC Screening Sites Plus Counties with 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 April 9, 2013 • 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
Thank you to all the partners who have made this program possible!
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