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Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW

TCCAP: a Targeted Awareness Program to Address Colorectal Cancer Disparities in Northeast Pennsylvania. Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW Northeast Regional Cancer Institute, Scranton, PA. Acknowledgement.

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Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW

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  1. TCCAP: a Targeted Awareness Program to Address Colorectal Cancer Disparities in Northeast Pennsylvania Samuel M. Lesko, MD, MPH Regina Schmid-Allen, MHA Laura Toole, LCSW Northeast Regional Cancer Institute, Scranton, PA

  2. Acknowledgement Supported by grants from:The Harry & Jeanette Weinberg Foundation, Scranton Area Foundation, Blue Ribbon Foundation, Margaret Briggs Foundation, Sordoni Foundation, Inc., Procter & Gamble Fund, Southern Union Co., Pennsylvania Department of Health, Pennsylvania Department of Community & Economic Development, and In-kind Support

  3. Northeast RegionalCancer Institute Non-profit, community based organization with a commitment to ease the burden of Cancer in Northeast Pennsylvania. • Cancer Registry • Research • Education and Support • Cancer Risk

  4. Partner Hospitals Community Medical CenterGeisinger South Wilkes-BarreMarian Community HospitalMercy Health PartnersMoses Taylor Hospital/Mid-Valley HospitalWayne Memorial Health SystemWyoming Valley Health Care System

  5. Appalachia Community Cancer Network (ACCN): Appalachian Areas of 7 States (KY, MD, NY, OH, PA, VA, WV)

  6. Background Colorectal cancer • 4th most common Ca in US • 2nd leading cause of Ca deaths in US • Screening can prevent CRCa deaths • Colorectal cancer in NEPA • Most commonly diagnosed Ca • 2nd leading cause of Ca death

  7. Cancer Cases, NEPA 1998-’02

  8. CRCa SIRs, Both Sexes, 1998-’02

  9. CRCa, Stage at Diagnosis,Both Sexes Percent

  10. Goals • To improve colorectal cancer screening rates • To improve the stage at which new colorectal cancer cases are diagnosed • To decrease colorectal cancer mortality rates

  11. Methods (1) Awareness Program • Multi-faceted • Community • Healthcare Providers • 3-year (2004-2006)

  12. Ellen Althouse, RN William Auriemma, MD Joseph Bannon, MD Michael Barrett, MD Valerie Bell, RN Maureen Besancon Derry Bird M.R. Chowdhury, MD Edward Dzielak, MD Mary Erwine, RN, MSN Pat Finan Marcie Grello, BS Linda Gutierrez, MD Mrs. Ceil Hughes Rita Ives, RN, AOCN David Kalinoski Jamie Kane Robert Kearns Susan Kennedy Doug Klamp, MD Michael Kondash, MD Lisa Kuter Bob Lamson Pat Lawless, MHA Ina Lubin Gail Matisko, RN, BSN John McGeehan, MD Sally McGuire Judge Carmen Minora Erin Moskel Peter C. Olden, PhD Stacey Ondik Dipti Pancholy, MD Bharat Patel, MD Paul Remick, MD Methods (2)Community Advisory Council David D. Reynolds, MD Judy Rogers, CRN David Rutta, MD Marie Santilli Karen Saunders Nayan C. Shah, MD Eileen Sharp, PhD Beth Taylor, RN, OCN Kristin Tigue Michael Turock, MD Kim Vangarelli Vera Walline, MPH, CHES Ann Ward Gloria Watson Barbara L. Winters, PhD Robert E. Wright, MD Eileen Zuber

  13. Methods (3) Community Interventions • Advertisements • Print, Billboards, Broadcast • Direct Mail • Screen for Life • Printed Materials • Educational Programs • CASUAL Day

  14. SM

  15. Methods (4) HCP Interventions • Didactic Presentations • Grand Rounds • Continuing Ed. • Academic Detailing • PCPs

  16. Evaluation • Questionnaires • HCP Follow-up Calls • Population Survey • Cancer Registry Data

  17. Results: Community (1) Community • 206 total community programs - 8,017 attendees • 46,510 targeted mail pieces • 59,725 total pieces of educational materials • 38,712,582 total individual market impressions

  18. Results: Community (2) Programs 97% Reported Knowledge Gain 96% Planned to Change Behavior Direct Mail 65% Reported Knowledge Gain 86% Planned to be Screened

  19. C.A.S.U.A.L. Day 2004-2006 • Team Captains – more than 400 businesses engaged • Participants – more than 12,000 • Money Raised – more than $124,000 raised to support Cancer Institute colon cancer awareness programming

  20. Results: HCP (1) Health Care Professionals • 21 hospital-based CME accredited programs - 852 attendees • 9 non-hospital programs - 250 attendees • 38 non-physician healthcare groups - 876 attendees • 230 physician “detailing” sessions

  21. Results: HCP (2) CME Programs 98% Reported Knowledge Gain 95% Planned to Change Behavior Detailing Sessions 44% Requested Additional Materials 75% Reported increased Patient Request for Screening 70% Reported Increased Screening

  22. Prevalence of Screening Lower Endoscopy* by Year, 2001-2006 Endoscopy Percent * Proportion of Adults Reporting Having Had a Screening Lower Endoscopy in the Previous Five Years

  23. Colorectal Cancer Stage at Diagnosisby Year*, 1998-2007 * NEPA, 6 counties

  24. Results: Mortality Too Early to Tell!

  25. Implications Based on: • Change in Stage @ Dx • Stage-specific Survival • Stable Incidence 13 Fewer Deaths per Year • $4,102/Year of Life Saved

  26. Discussion • Sustainable – Cost/YOLS Modest • Community Effort – Media, CASUAL Day • Limitations – No Control – FOBT Use • Long Term Effects - Unknown

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