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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/25547926 below:

Colon cancer screening for Colorado's underserved: a community clinic/academic partnership

doi: 10.1016/j.amepre.2014.09.016. Epub 2014 Dec 26. Colon cancer screening for Colorado's underserved: a community clinic/academic partnership Andrea Dwyer², Dennis J Ahnen³, Shannon L Pray⁴, Susan M Rein³, Krystal D Morwood⁵, Jan T Lowery⁶, Andrea Masias⁷, Nicole J Collins⁵, Carol E Brown², Carol-Ann DeMaio Goheen², Keavy E McAbee², Angela Sauaia⁸, Tim E Byers⁹

Affiliations

¹ Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: holly.wolf@ucdenver.edu.
² Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
³ Division of Gastroenterology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁴ University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁵ Preventive Services Division, Colorado Department of Public Health and Environment, Denver, Colorado.
⁶ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁷ Colorado Access, Colorado Department of Public Health and Environment, Denver, Colorado.
⁸ Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁹ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado; University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

PMID: 25547926
DOI: 10.1016/j.amepre.2014.09.016

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Colon cancer screening for Colorado's underserved: a community clinic/academic partnership

Holly J Wolf et al. Am J Prev Med. 2015 Mar.

doi: 10.1016/j.amepre.2014.09.016. Epub 2014 Dec 26. Authors Holly J Wolf¹, Andrea Dwyer², Dennis J Ahnen³, Shannon L Pray⁴, Susan M Rein³, Krystal D Morwood⁵, Jan T Lowery⁶, Andrea Masias⁷, Nicole J Collins⁵, Carol E Brown², Carol-Ann DeMaio Goheen², Keavy E McAbee², Angela Sauaia⁸, Tim E Byers⁹ Affiliations

¹ Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado. Electronic address: holly.wolf@ucdenver.edu.
² Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
³ Division of Gastroenterology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁴ University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁵ Preventive Services Division, Colorado Department of Public Health and Environment, Denver, Colorado.
⁶ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁷ Colorado Access, Colorado Department of Public Health and Environment, Denver, Colorado.
⁸ Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
⁹ Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado; University of Colorado Cancer Center, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

PMID: 25547926
DOI: 10.1016/j.amepre.2014.09.016

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Abstract

Background: Colorectal cancer (CRC) is largely preventable by finding and removing adenomas, but many people have not been screened, especially the uninsured with low income.

Purpose: To establish a statewide infrastructure to ensure that low-income Coloradans receive colonoscopy for CRC screening and diagnostic evaluation.

Design: In 2006, a statewide program to provide free colonoscopy to uninsured Coloradans was developed as a partnership between the University of Colorado Cancer Center and Colorado safety-net clinics. Funded by excise tax revenues, the Colorado Colorectal Screening Program (CCSP) successfully embedded screening into primary care, providing patient navigation support and reimbursement that allowed primary care providers to refer patients for colonoscopy.

Setting/participants: More than 50 safety-net clinics joined the CCSP to provide colonoscopies to uninsured Coloradans with low income, aged ≥50 years or <50 years at elevated risk, lawfully present and needing CRC screening by American Cancer Society consensus guidelines.

Main outcome measures: Process and clinical outcomes included people screened, show rates, patient satisfaction, and quality measures, such as adenoma detection rate, bowel cleansing quality, and timeliness of care. Program costs and benefits were estimated. The 2013 analysis was completed using 2006-2012 data on 13,252 of 13,774 people receiving colonoscopy.

Results: In 2006-2012, the CCSP screened 13,774 people, with 38% minorities and 39% men. Patient navigators ensured >90% of those referred attended their colonoscopy. Adenomas were removed from 27% of patients and 1% had cancers diagnosed. Total direct medical services cost was $998/person receiving colonoscopy. About 325 fewer future incident CRCs were predicted due to adenoma removal, projecting substantial future cost savings.

Conclusions: The CCSP, a successful community clinic/academic partnership provides cost-effective CRC screening and prevention services to low-income uninsured Coloradans and establishes the infrastructure to support screening low-income Coloradans as Affordable Care Act reforms provide payer coverage for them.

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