Experience of a Public Health Colorectal Cancer Testing Program in Maryland

Dwyer, Diane M.; Groves, Carmela; Hopkins, Annette; Keelaghan, Eithne F.; Shebl, Fatma M.; Andrews, B; Bienia, Marsha; Steinberger, Eileen K.

doi:10.1177/003335491212700313

Cited by 5 publications

(7 citation statements)

References 13 publications

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“…Nearly all local health departments (23 of 24) chose CRC screening as their primary cancer prevention intervention in addition to their routine work related to infections, tobacco control, etc. Activating this statewide plan required considerable collaboration and CRC education at multiple levels of the state coalition through learning sessions and meetings; the state coalition included policy makers, employers, health educators, outreach workers, case managers/navigators, the general public, third‐party payers, primary care providers, medical specialists, treatment teams, and a group of researchers to add an evaluation component to the program . The funding was allocated to the state health department and was then distributed to the 23 participating local health departments.…”

Section: Review Of Model Programsmentioning

confidence: 99%

“…Activating this statewide plan required considerable collaboration and CRC education at multiple levels of the state coalition through learning sessions and meetings; the state coalition included policy makers, employers, health educators, outreach workers, case managers/navigators, the general public, third-party payers, primary care providers, medical specialists, treatment teams, and a group of researchers to add an evaluation component to the program. 58 The funding was allocated to the state health department and was then distributed to the 23 participating local health departments. The requirements for local health departments included: 1) creating local coalitions with health care providers and representatives of all population groups within the county, 2) delineating local CRC comprehensive cancer plans, and 3) implementing plans that included educating the local population, screening the uninsured or underinsured low-income population, and linking to treatment centers.…”

Section: National Demonstration Program (Cdc)mentioning

confidence: 99%

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Population‐based programs for increasing colorectal cancer screening in the United States

Sarfaty

Brooks

Wender

2015

CA A Cancer J Clinicians

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Answer questions and earn CME/CNE Screening to detect polyps or cancer at an early stage has been shown to produce better outcomes in colorectal cancer (CRC). Programs with a population-based approach can reach a large majority of the eligible population and can offer cost-effective interventions with the potential benefit of maximizing early cancer detection and prevention using a complete follow-up plan. The purpose of this review was to summarize the key features of population-based programs to increase CRC screening in the United States. A search was conducted in the SCOPUS, OvidSP, and PubMed databases. The authors selected published reports of population-based programs that met at least 5 of the 6 International Agency for Research on Cancer (IARC) criteria for cancer prevention and were known to the National Colorectal Cancer Roundtable. Interventions at the level of individual practices were not included in this review. IARC cancer prevention criteria served as a framework to assess the effective processes and elements of a population-based program. Eight programs were included in this review. Half of the programs met all IARC criteria, and all programs led to improvements in screening rates. The rate of colonoscopy after a positive stool test was heterogeneous among programs. Different population-based strategies were used to promote these screening programs, including system-based, provider-based, patient-based, and media-based strategies. Treatment of identified cancer cases was not included explicitly in 4 programs but was offered through routine medical care. Evidence-based methods for promoting CRC screening at a population level can guide the development of future approaches in health care prevention. The key elements of a successful population-based approach include adherence to the 6 IARC criteria and 4 additional elements (an identified external funding source, a structured policy for positive fecal occult blood test results and confirmed cancer cases, outreach activities for recruitment and patient education, and an established rescreening process).

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Section: Review Of Model Programsmentioning

confidence: 99%

Section: National Demonstration Program (Cdc)mentioning

confidence: 99%

Population‐based programs for increasing colorectal cancer screening in the United States

Sarfaty

Brooks

Wender

2015

CA A Cancer J Clinicians

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“…Nevertheless, the response rate to the distribution of free FOBT kits was surprising, especially among minority populations such as Hispanics who are often noted as facing barriers to screening [5, 12-15]. Other studies have distributed free FOBT kits through mail [16-18], clinic visits [19-23], community retail stores [24, 25], and through pharmacies [26, 27]. None experienced response rates as high as those seen in this study.…”

Section: Discussionmentioning

confidence: 99%

An Innovative Strategy to Reach the Underserved for Colorectal Cancer Screening

et al. 2014

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Hispanics are an underserved population in terms of colorectal cancer (CRC). CRC is the second leading cause of cancer incidence among Hispanic men and women and Hispanics have lower screening rates than non-Hispanic whites. The overall purpose of this project was to provide CRC information, education, and fecal occult blood test (FOBT) kits to Hispanics in a rural three-county region of Washington State. We held a series of 47 community health fair events that incorporated the use of a giant inflatable, walk-through colon model with physical depictions of healthy tissue, polyps, and CRC. We used a pre/post-design to look for changes in familiarity with CRC before and after walking through the colon among adults 18 and older (n=947). McNemar's test analysis indicated significant differences in the distribution of the percentage of correct participant responses to CRC-related questions from pre- to post-test after an educational tour of the colon. Results from logistic regression analysis identified multiple participant characteristics associated with self-reported likelihood of being screened for CRC in the three months following post-test. We distributed 300 free FOBT kits to be analyzed at no charge to the end-user to attendees aged 50 and older who toured the inflatable colon; 226 FOBT kits (75.3%) were returned for analysis. The use of the inflatable colon was an innovative way to attract people to learn about CRC and CRC screening modalities. Furthermore, the response to our distribution of FOBT kits indicates that if given the opportunity for education and access to services, this underserved population will comply with CRC screening.

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“…For the CRF program, colonoscopy was preferred because it provided screening, diagnosis, and primary prevention through polypectomy; there was sufficient capacity for colonoscopy; and a resultant screening interval of 10 years for average‐risk clients simplified patient support services such as case management. Moreover, CRF programs in Maryland that first selected fecal occult blood tests (FOBTs) with sigmoidoscopy switched to colonoscopy during the initial 3 years because of the above reasons . A second factor influencing test selection was the influence of hospital gastroenterologists involved in the planning who recommended colonoscopy.…”

Section: Program Planning and Developmentmentioning

confidence: 99%

“…3 With their CRF funding in 2000, 23 of Maryland's 24 jurisdictions prioritized colorectal cancer, developed education and/or screening programs for their populations, and focused their enrollment for colorectal screening on underinsured and uninsured persons. 4 In contrast, Baltimore city, in collaboration with its Community Health Coalition, selected prostate, oral, breast, and cervical cancer as priority areas for screening and outreach rather than colorectal cancer. As a result, underserved residents of Baltimore city continued to lack access to no-cost colorectal cancer screening services.…”

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confidence: 99%

Collaborating across multiple health care institutions in an urban colorectal cancer screening program

Villanueva

Gugel

Dwyer

2013

Cancer

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BACKGROUND Maryland, excluding Baltimore City, began public health screening for colorectal cancer in 2000. Initiating colorectal cancer screening in Baltimore City was an objective in the Maryland Comprehensive Cancer Control Plan. The Centers for Disease Control and Prevention's (CDC's) funding announcement for the “Colorectal Cancer Screening Demonstration Program” (CRCSDP) was seen as a potential opportunity for Maryland to begin screening in Baltimore City. METHODS The Maryland Department of Health and Mental Hygiene (DHMH), the American Cancer Society, and five Baltimore City Hospitals collaborated to develop the funding application and model for the Baltimore City CRCSDP. After receipt of funding, between 2005 and September 2009, screening sites collaborated with the DHMH to implement the multi‐site colorectal cancer screening program in Baltimore City. RESULTS Close collaboration across organizational boundaries enabled the funding, formation, and implementation of the CRCSDP in Baltimore City. The Baltimore City CRCSDP illustrates the complexity of establishing a functional public health screening program. The program overcame expected and unexpected fiscal, programmatic, and clinical challenges to successfully perform 709 colonoscopies screening cycles among 696 people and detect three cancers during the 38 months of screening. CONCLUSIONS Partnerships among the state and local health department, the American Cancer Society, and hospitals in Baltimore City enabled the implementation of this successful program. Lessons learned from the collaborative planning process and the program implementation may facilitate similar collaborations in other geographic areas. Cancer 2013;119(15 suppl):2905–13. © 2013 American Cancer Society.

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Experience of a Public Health Colorectal Cancer Testing Program in Maryland

Cited by 5 publications

References 13 publications

Population‐based programs for increasing colorectal cancer screening in the United States

Population‐based programs for increasing colorectal cancer screening in the United States

An Innovative Strategy to Reach the Underserved for Colorectal Cancer Screening

Collaborating across multiple health care institutions in an urban colorectal cancer screening program

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