Engaging health systems to increase colorectal cancer screening: community-clinical outreach in underserved areas of Wisconsin

Abstract

Background: Colorectal cancer is the fourth most commonly diagnosed cancer and the second leading cause of cancer-related death in Wisconsin. Incidence and mortality rates for colorectal cancer vary by age, race/ethnicity, geography, and socioeconomic status. From 2010 through 2012, the Wisconsin Comprehensive Cancer Control Program awarded grants to 5 regional health systems for the purpose of planning and implementing events to increase colorectal cancer screening rates in underserved communities.

Community context: Grantees were chosen for their ability to engage community partners in reaching underserved groups including African American, Hispanic/Latino, Hmong, rural, and uninsured populations in their service areas.

Methods: Grantees identified target populations for proposed screening events, designated institutional planning teams, engaged appropriate local partner organizations, and created plans for follow-up. All grantees implemented 1 or more colorectal cancer screening events within 6 months of receiving their awards. Events were conducted in 2 phases.

Outcomes: Participating health systems organized 36 screening events and distributed 633 individual test kits; 506 kits were returned, of which 57 (9%) tested positive for colorectal abnormalities. Of attendees who received screening, 63% were uninsured or underinsured, 55% had no previous screening, 46% were of a racial/ethnic minority group, 22% had a family history of cancer, and 13% were rural residents. This project strengthened partnerships between health systems and local organizations.

Interpretation: An effective strategy for improving colorectal cancer screening rates, particularly among underserved populations, is to award health systems grants for implementing community-based screening events in conjunction with community partners.

Figure 1

Sociodemographic characteristics of eligible Wisconsin adults screened for colorectal cancer in conjunction with the Wisconsin Comprehensive Cancer Control Program screening events grant project, as a percentage of the total number offered screening. Participants (n = 633) may be counted in more than 1 category. [Table: see text]

Figure 2

Total fecal immunochemical blood test (iFOBT) kits distributed, returned, and testing positive for abnormalities in Phases I and II of the Wisconsin Comprehensive Cancer Control Program colorectal cancer screening events grant project.