East Texas is highly rural and low-income, with many uninsured. We initiated a .... Northeast/University of Texas System Office of Population Health. Contact.
Increasing Access to Colorectal Cancer Screening in Rural East Texas Carlton Allen, M.S¹; Gabriela Orsak, PhD¹; William Sorensen, PhD²; Paul McGaha, DO, MPH¹ ¹The University of Texas Health Science Center, Tyler, TX 75708, ²University of Texas at Tyler, Tyler, TX 75799
Overview In the United States, colorectal cancer (CRC) is the fourth most frequently diagnosed cancer. In 2013, 136,119 people were diagnosed with CRC, with 51,813 dying from the disease. Compared to Texas as a whole, East Texas has higher incidence and mortality rates from Colorectal cancer (CRC) . CRC screening rates are lowest among the uninsured. East Texas is highly rural and low-income, with many uninsured. We initiated a CRC screening program in East Texas, focusing on the un- and under-insured. CRC screening saves lives, yet screening rates among underserved populations, such as the uninsured and minorities, are low. CRC screening in asymptomatic patients can reduce the incidence and mortality of CRC as it: 1) Prevents CRC by polypectomy, 2) Finds early-stage cancers, leading to treatment with a high chance for long term survival, and 3) Identifies families at increased risk.
Objective Our goals included: 1)Increase CRC screening education and access by providing CRC screening riskbenefit education to individuals in the catchment area. 2)Increase the rate of CRC screening services by at least 10%, by tailoring support for CRC screening to the individual’s intention.
Methods The CRC screening project, funded by the Cancer Prevention Institute of Texas (CPRIT), encompasses 19 counties in East Texas. The catchment area is primarily rural, with limited access to public transportation. Patients had the choice to elect whether they would like to receive a colonoscopy or a FIT test. Participants included: • Individuals at least 45 to 76 years of age • Underwent a colonoscopy and/or FIT test • Data was collected between 2014 and 2016 • Exclusion included having previously been diagnosed with CRC in the past.
Results Between September 1, 2016 and August 31, 2017 (end of Year Three) there were 3,374 colorectal cancer screenings through this CPRIT grant, as opposed to Year One’s 1,337 screenings, and Year Two’s 2,417 screenings. Year Three is a 39.6% increase over Year Two. Table 1: Cases (%) showing Demographic differences by Year Three vs. Previous years Years One & Two Year Three Agea (average) Sexb# Male Female Ethnicityb# African American Hispanic White Insurance statusb Insured Uninsured
60.3
58.6**
1,424 (37.9) 2,312 (61.6)
892 (36.0) 1,525 (64.0)*
920 (24.5) 398 (10.6) 2,401 (64.0)
2,489 (66.5) 1,256 (33.5)
659 (19.5) 868 (25.7)** 1,814 (53.8)
1,285 (38.1) 2,089 (61.9)**
Type Colonoscopy 2975 1836 FIT 758 1538 Total 3754 3374 **p
