1 / 22

Colorectal Cancer Screening Capacity in Montana

Colorectal Cancer Screening Capacity in Montana. Montana DPHHS Survey, 2008 . Colorectal Cancer Screening. High priority for MT DPHHS 3rd most common cancer ~ 80% is preventable Good screening tests exist Screening underutilized. Recommendations. US Preventive Services Task Force, 2008

obert
Download Presentation

Colorectal Cancer Screening Capacity in Montana

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Colorectal CancerScreening Capacity in Montana Montana DPHHS Survey, 2008

  2. Colorectal Cancer Screening • High priority for MT DPHHS • 3rd most common cancer • ~ 80% is preventable • Good screening tests exist • Screening underutilized

  3. Recommendations • US Preventive Services Task Force, 2008 • Combined Expert Panel, 2008 • American Cancer Society • US Multi-Society Task Force on Colorectal Cancer • American College of Radiology

  4. Two Approaches • Direct examination • Colonoscopy • Flexible sigmoidoscopy • Double contrast barium enema • Virtual colonoscopy • Fecal testing

  5. Direct Examination • Greater potential to prevent CRC • More sensitive and specific • Bowel preparation • Cost

  6. Fecal Testing • Finds existing CRC • Not usually preventive • Less sensitive and specific • No bowel preparation • Inexpensive

  7. Sensitivity and Specificity • Test characteristics • Sensitive = doesn't miss disease if it exists • Specific = few false positives

  8. Task Forces Recommend • Universal CRC screening • Direct examination preferred • Fecal testing acceptable ONLY IF ANNUAL

  9. CRC Screening Underutilized in Montana • Only 65% of adults age 50+ up to date on screening • 53% ever had endoscopy • 28% FOBT within 2 years Montana BRFSS 2006

  10. CRC Screening Need Great in Montana • Estimated unscreened population • 143,000 in 2008 • Will increase to • 160,000 in 2020 • Unless screening participation increases

  11. MT DPHHS • Initiative to increase CRC screening • Screening methods to recommend depend on available capacity

  12. National Surveys of CRC Screening Capacity • Cannot meet demand • If everyone age 50+ chooses colonoscopy

  13. National Surveys of CRC Screening Capacity • No limitation • If everyone age 50+ chooses fecal testing

  14. Question • Is universal colonoscopy screening feasible in Montana?

  15. Feasiblity • Facilities to perform colonoscopy • Personnel • Cost to patients / insurance • Patient attitudes and beliefs

  16. MT DPHHS Survey • Identified all hospitals and ambulatory centers performing • 8-question survey • Refer to scheduling or billing records

  17. Response • 41 hospitals perform c'scopy • 40 returned surveys • Got info from M.D. for nonresponding hospital • 3 ambulatory centers • Affiliated with large hospitals • All returned surveys

  18. 13 urban General surgeons and gastro-enterologists 7 week wait 30 rural Internists and family practitioners 2 week wait Characteristics

  19. Urban 15,000 screens per year Could do 21,00 more 26% of total screen capacity unused Rural 4,000 screens per year Could do 22,000 more 81% of total screen capacity unused Characteristics

  20. Montana Has Unused Colonoscopy Screening Capacity • Unequally distributed • More total capacity in urban areas • More unused capacity in rural areas

  21. Conclusion • Every adult age 50 and older can and should be screened for colorectal cancer

More Related