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The Colorado Colorectal Screening Program aims to reduce colorectal cancer incidence and mortality among Coloradans aged 50 and older. Since its inception in 2006, the program has provided endoscopic screening for uninsured individuals under 250% of the Federal Poverty Level. With evidence showing that screening methods like FOBT, sigmoidoscopy, and colonoscopy can significantly lower cancer mortality rates, the program promotes screening accessibility, public outreach, and comprehensive patient support. Join our efforts to increase screening rates and save lives.
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Colorado Colorectal Screening Program Holly Wolf University of Colorado School of Medicine Holly.Wolf@uchsc.edu 303-724-1273
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
Colorectal cancer mortality, US and Colorado United States Cancer Statistics: 1999–2002 www.cdc.gov/cancer/npcr/uscs.
5-year colorectal cancer survival in Colorado by proportion of neighborhood in poverty 5-Year CRC survival CRC in Colorado
CRC screening trends, US and Colorado Non-Hispanic Whites % Hispanics
Colorado Colorectal Screening Program • Funded by revenues from a tobacco tax • Began in January 2006, expanded statewide in November 2006 • Partnership with community clinics
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.
Program Components • Endoscopic screening in clinics or by referral • Follow-up and Rx • Patient navigation support • Capacity development • Public outreach & marketing • Evaluation
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
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
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
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
Programinformation • www.uccc.info/colonscreen • CCSP coordinating center: 1-866-909-3481 • ACS help line: 1-866-227-7194
The Colorado Colorectal Screening Program Tim Byers, MD, MPH Angela Sauaia, MD Susan Rein, RN Andrea Dwyer BS Jan Lowery, PhD Holly Wolf, PhD
