BACKGROUND: The objectives of the current study were to assess changes in colorectal cancer (CRC) screening uptake and the cost-effectiveness of implementing multiple evidence-based interventions (EBIs). EBIs were implemented at 2 federally qualified health centers that participated in the Colorado Department of Public Health and Environment’s Clinic Quality Improvement for Population Health initiative. METHODS: Interventions included patient and provider reminder systems (health system 1), provider assessment and feedback (health systems 1 and 2), and numerous support activities (health systems 1 and 2). The authors evaluated health system 1 from July 2013 to June 2015 and health system 2 from July 2014 to June 2017. Evaluation measures included annual CRC screening uptake, EBIs implemented, funds received and expended by each health system to implement EBIs, and intervention costs to the Colorado Department of Public Health and Environment and health systems. RESULTS: CRC screening uptake increased by 18 percentage points in health system 1 and 10 percentage points in health system 2. The improvements in CRC screening uptake, not including the cost of the screening tests, were obtained at an added cost ranging from $24 to $29 per person screened. CONCLUSIONS: In both health systems, the multicomponent interventions implemented likely resulted in improvements in CRC screening. The results suggest that significant increases in CRC screening uptake can be achieved in federally qualified health centers when appropriate technical support and health system commitment are present. The cost estimates of the multicomponent interventions suggest that these interventions and support activities can be implemented in a cost-effective manner.
This year, 2018, marks the 20th year that the Centers for Disease Control and Prevention (CDC) has supported the United States National Comprehensive Cancer Control Program (NCCCP). The NCCCP emerged from a movement called comprehensive cancer control (CCC), which began as a concept in 1994 and is focused on addressing cancer in a comprehensive manner, across the continuum of cancer control rather than focusing in on one cancer site (e.g., colorectal) or only on one aspect of care delivery (e.g., prevention). CCC is an approach that brings together multi-sector partners to collectively address the cancer burden in a community by leveraging existing resources and identifying and addressing cancer-related issues and needs. In 1999, the Comprehensive Cancer Control National Partnership (CCCNP) was officially formed, bringing together key federal and national cancer stakeholders to support the NCCCP and their CCC coalitions as they develop and implement CCC plans. This is the third Special Issue on CCC, all published in Cancer Causes and Control. In this Special Issue, we offer reflections on the progress made over the past 20 years in addressing the US cancer burden through the CCC approach and present a range of topics, from a description of how CCC programs and coalitions have evolved over the years to analyses of how they can affect change through policy,
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