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March 15, 2012
By Claudene Wharton
A strong collaborative pilot project in Washoe County has found success in seeking ways to encourage those who need colon cancer screenings to get them. And, the Centers for Disease Control and Prevention has awarded the state's Health Division $3 million to take the project statewide.
It is recommended that all men and women be screened for colon cancer when they reach the age of 50, yet only about 56 percent of Nevadans over age 50 have done so. However, in Washoe County, collaborative, creative efforts have steadily increased the screening rate, bringing it from about 50 percent in 2006, to 56 percent in 2008, and to about 63 percent in 2010.
"That's about a 10 percent increase in the screening rate, just from 2008 to 2010, and brings the county almost up to the national average screening rate of 65 percent," said Paul Devereux, associate professor at the University of Nevada, Reno School of Community Health Sciences, who is helping with the effort. "We're very happy with that. We think we can take what we've done here over the past couple of years and implement it statewide, improving the entire state's screening rate, and most importantly, saving more lives."
The Nevada Colon Cancer Partnership got to work in 2008, implementing a broad range of activities, including media campaigns, other outreach methods and, most recently, "screening patient navigators," a part of the program that Devereux headed up with the Nevada Cancer Institute, working with local clinics. "Screening patient navigators" were hired and trained, with the charge of contacting those thought most in need of being screened but least likely to do so, and then helping them "navigate" through the system to get screened. A strong emphasis was put on outreach to the Latino population, which historically has very low rates of colon cancer screening, in Nevada, only about 35 percent.
Devereux said that despite the many barriers of those in the group they reached out to—fear, embarrassment, cultural, transportation, resources, etc.—they were able to get 58 percent of those eligible for screening to be screened. Seventy one percent of those screened reported they had never been screened before. Most importantly, of those who had colonoscopies, 38 percent, or 82 people, had at least one polyp, and one person had a cancer presence reported.
The importance of catching polyps was underscored just last month when two separate studies reported in the New England Journal of Medicine strongly suggested, for the first time, that removing polyps discovered during colonoscopies cuts the risk of dying from colon cancer in half. Colon cancer is the second most common cause of death from cancer in men and women in the United States, and fourth most common worldwide.
The screening patient navigator program was supported by $680,000 in grant funds from the National Institutes of Health, as part of the Nevada INBRE (IDeA Network of Biomedical Research Excellence) Program at the Nevada School of Medicine, directed by Dr. Jim Kenyon.
Since the success of this program and the other outreach efforts of the Nevada Colon Cancer Partnership, the partnership teamed up with the state to help the state apply for a CDC grant to increase screening rates statewide. The result was a $3 million grant awarded to the Nevada State Health Division, with some of the funds being distributed to the partnership for outreach and awareness activities, and some of the funds going to Access to Healthcare Network to coordinate the screening process.
Access to Healthcare Network is a statewide organization serving mostly the uninsured. One of the "screening patient navigators" from the pilot program in the north will now work for the network to supervise a team of health-care workers and screening patient navigators statewide to do the same type of outreach and follow-up with patients that was so successful in getting patients screened in the pilot program in the north.
"This program is a model for what can happen when community organizations, health-care providers and higher education institutions come together to address a problem," Devereux said. "Those of us in higher education seek to help design and test pilot programs in order to find successful ways to address public health issues that they can be applied on a broader scale to benefit the state and beyond. In this case, we've done that. We look forward to continuing our work with the partnership to get more Nevadans screened and save more lives."
As March is National Colorectal Cancer Awareness Month, Devereux said all Nevadans age 50 and older who have not been screened are encouraged to talk to their health provider about being screened. For details about free colon cancer screening, people without insurance, or who are underinsured and meet certain income restrictions, should call Access to HealthCare Network at (877) 385-2345.