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Cigarette Restitution Fund Colorectal Cancer Program—Update November, 2003

Cigarette Restitution Fund Colorectal Cancer Program—Update November, 2003. Diane M. Dwyer Center for Cancer Surveillance and Control Maryland Dept. of Health and Mental Hygiene. THANKS:. University of MD Team Eileen Steinberger Annette Hopkins Min Zhan Jane Uman Ebenezer Israel.

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Cigarette Restitution Fund Colorectal Cancer Program—Update November, 2003

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  1. Cigarette Restitution FundColorectal Cancer Program—UpdateNovember, 2003 Diane M. Dwyer Center for Cancer Surveillance and Control Maryland Dept. of Health and Mental Hygiene

  2. THANKS: University of MD Team Eileen Steinberger Annette Hopkins Min Zhan Jane Uman Ebenezer Israel DHMH Staff Carmela Groves Alyse Weinstein Lorraine Underwood Eugene Small 25 Maryland Local PH Programs

  3. Maryland Cigarette Restitution Fund Allocation—FY03 $ 202 Million

  4. CRF Budget—Local PH $ in Millions

  5. Create a Network through Partnerships and Contracts

  6. State Health Dept. Program 25 Local PH Programs Providers: Doctors Labs, Hospitals, Pharmacies 24 Community Health Coalitions Minority Outreach, Technical Assistance 2 Statewide Academic Health Centers: Research, PH, Statewide Health Network Community based orgs. Faith based organizations Volunteers Maryland Citizens, esp. Minority & Underserved CRF Cancer Control “Network”

  7. Local PH—Number of Contracts for Education/Outreach/Media Services* ~ 75 from 17 programs ~ 68 from 17 programs ~ 46 from 14 programs * Non fee-for-service to CBO, Minority, Faith-based, Education, Advertising

  8. Local PH CRF Programs—Number of Contracts for Medical Services* 605 336 * Fee-for-Service for Providers, Hospitals, Labs, Pharmacies, Radiology

  9. Colorectal Cancer CRF Programs • 23 of 24 jurisdictions chose to focus on colorectal cancer (not Baltimore City) • Screening began ~January, 2001 • 22 jurisdictions screening for colorectal cancer under CRF funding in FY04

  10. CRC Medical Advisory Committee • Medical experts • Advise program on screening procedures, screening intervals • Formulated Minimal Elements for CRC Screening

  11. Colorectal CancerEducation and Outreach

  12. Colorectal Cancer--Number Educated by Type of Audience Maryland, June 2000-November 4, 2003 N = 151,507 Source: Education Database, Form 1 as of November 4, 2003

  13. General Public CRC Education (Brief, Individual, and Group) by Quarter and Minority Status Source: Education Database, Form 1 as of November 4, 2003

  14. Media, Newspaper, Pamphlets, Billboards, etc. • July 2000—November 4, 2003: Colorectal cancer messages targeted to reach >22 million people

  15. Colorectal CancerScreening and Treatment

  16. Washington County Colonoscopies, 2001-2003 Washington Co. CRC program began 2002 2003 2001

  17. Colorectal Cancer Screening >50 years oldMaryland Cancer Survey--2002

  18. Current CRC Screening Status of Marylander’s >50 years old—Maryland Cancer Survey, 2002 *UTD—Up to date per ACS options for screening

  19. Colorectal Cancer CRF Public Health Program Screening Data

  20. Summary of CRF CRC Screening As of October 30 2003: 6,523 FOBTs 129 sigmoidoscopies 3,976 colonoscopies * Using “highest numbers” reported to DHMH

  21. CRC Screening by GenderMaryland FY01-present

  22. CRC Screening by MinorityMaryland FY01-present

  23. CRC Screening by Minority and GenderMaryland FY01-present

  24. Persons Screened* for CRC by Minority Status, Maryland 7/1/00-6/30/03 42% Minority *Screened with FOBT, Sig., or Colonoscopy—DHMH database

  25. CRF CRC Screening Results * Using “Highest numbers” ** Using those in DHMH database As of October 30, 2003

  26. CRF CRC Screening Results* * Using those in DHMH database; as of October 30, 2003

  27. Other Findings on Colonoscopy • 46% of colonoscopies without adenomatous polyps or cancer had other findings: • Non-adenomatous polyps • hemorrhoids • diverticular disease • inflammatory bowel disease • other

  28. CRF CRC ScreeningComplications of ~3,700 Colonoscopies (with and without biopsy)

  29. * * Pay for service until funds are depleted

  30. Lessons • 45 colorectal cancers detected; over 70 cancers possibly prevented through polyp removal • An effective colorectal cancer screening program for the under-served (uninsured and low income) is possible • Services well received by providers and the community • Programs shifted from FOBT-sig to colonoscopy • Complications happen (at expected frequency) • More difficult to reach men

  31. Challenges • Budget cuts • How to screen those not covered by a program or insurance • How to pay for diagnosis and treatment • Incorporating new CRC screening methods

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