Recorded presentation

Mona Sarfaty, MD, Prevention and Community Health, George Washington University School of Public Health and Health Services, 8900 Fernwood Road, Bethesda, MD 20817, 240-338-7255, monasarfaty@yahoo.com

Montgomery County established a colorectal cancer (CRC) program, as part of the Maryland cancer program, that increased access to screening for colorectal cancer by providing free colonoscopy to low income uninsured residents > age 50. The goals of the CRC program were to reduce mortality and eliminate disparities. The principal outcome measure was completed colonoscopies. The CRC program had education and clinical components. At least 50% of those educated were supposed to be minorities. Education included substantial outreach and was multifaceted and community based. It involved brief standing, and full sit-down, sessions at diverse locations offered by staff with varied levels of training who represented a variety of partners, including minority organizations. The CRC clinical component was contracted to a community non-profit organization that worked closely with the local community clinics. Both the education sessions--and direct referrals from the community clinics--were routes of entry to the clinical program. A registered nurse (RN) in the clinical program handled all communications regarding colonoscopy, met with every patient, made referrals to doctors, and provided ongoing continuity and case management. Over two years from July 2001 through June 2003, 1676 uninsured individuals participated in the program. Latinos constituted more than half the population. Only 11.1% of this population had received prior FOBT screening; 3.2% had prior colonoscopy and 1.6% had prior flex sig. Over two years, 696 (41.5%) uninsured individuals completed a colonoscopy (11 had FOBT plus flex sig). The Healthy People 2010 objective for colorectal cancer screening is 50%. There were 251 (36%) patients with polyps, 80 (11.5%) with adenomatous polyps, and 8 (1.1%) with CRC.

Learning Objectives: At the conlusion of this session, the participant will be able to

• List the accepted modes of screening for colorectal cancer.
• Be aware of the disparities in mortality from colorectal cancer.
• Define the objectives from Healthy People 2010 for colorectal cancer screening
• Discuss the validity of the 2010 baseline for colorectal cancer screening with regard to the uninsured
• Assess the impact of access to screening on screening rates for an uninsured minority population.

Keywords: Cancer Screening, Community Preventive Services

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation