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Colorado Colorectal Screening Program

Colorado Colorectal Screening Program. Holly Wolf University of Colorado School of Medicine Holly.Wolf@uchsc.edu 303-724-1273. Colorful Colorado. Map of Colorado. Colorectal Cancer in Colorado. Second leading cause of cancer death - Each year, 1690 diagnosed and 620 die

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Colorado Colorectal Screening Program

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  1. Colorado Colorectal Screening Program Holly Wolf University of Colorado School of Medicine Holly.Wolf@uchsc.edu 303-724-1273

  2. Colorful Colorado

  3. Map of Colorado

  4. Colorectal Cancer in Colorado • Second leading cause of cancer death - Each year, 1690 diagnosed and 620 die • Screening can reduce incidence (polyp removal) • Screening can also reduce mortality • FOBT by 30% • Sigmoidoscopy by up to 50% • Colonoscopy by up to 80% • Only 55% Coloradans ages 50+ are screened • 66% ages 65 + (Medicare) • 52% ages 50-64 with health insurance • 26% ages 50-64 without health insurance

  5. Colorectal cancer mortality, US and Colorado United States Cancer Statistics: 1999–2002 www.cdc.gov/cancer/npcr/uscs.

  6. 5-year colorectal cancer survival in Colorado by proportion of neighborhood in poverty 5-Year CRC survival CRC in Colorado

  7. CRC screening trends, US and Colorado Non-Hispanic Whites % Hispanics

  8. Colorado Colorectal Screening Program • Funded by revenues from a tobacco tax • Began in January 2006, expanded statewide in November 2006 • Partnership with community clinics

  9. Approach • Provide endoscopic colorectal screening to Coloradans without health insurance who are under 250% Federal Poverty Level and who need screening • Encourage all Coloradans ages 50 and older to get screened.

  10. Program Components • Endoscopic screening in clinics or by referral • Follow-up and Rx • Patient navigation support • Capacity development • Public outreach & marketing • Evaluation

  11. Program Eligibility • 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

  12. Need for screening • Assessed by primary care provider using consensus screening/surveillance guidelines • Average risk – 50 years and older • Increased risk - under 50 • Family history of colorectal cancer or adenomatous polyps • Personal history of adenomas or colorectal cancer • High risk – Under 50 • Family history of FAP or HNPCC • Personal history of IBD for 8 years or longer • Symptomatic - 45 years or older

  13. Findings from the first 925 CCSP colonoscopies • 65% female • 47% Hispanic • 8% African American • 99% had an adequate exam • 21% had adenomas • 1% had cancer

  14. Goals • Implement statewide screening asap • Seamless program management • Patient navigation and support • Flexibility for new screening methods • Screen approx 3000 per year • Year 2010 objectives of 75% screening compliance among uninsured

  15. Programinformation • www.uccc.info/colonscreen • CCSP coordinating center: 1-866-909-3481 • ACS help line: 1-866-227-7194

  16. The Colorado Colorectal Screening Program Tim Byers, MD, MPH Angela Sauaia, MD Susan Rein, RN Andrea Dwyer BS Jan Lowery, PhD Holly Wolf, PhD

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