March is Colorectal Cancer Awareness Month.
The Florida Prevention Research Center (FPRC) at the USF College of Public Health is focusing on a core research project to understand the factors impacting colorectal cancer screenings (CRCS) and to identify effective strategies to increase screening rates.
FPRC, a member of the CDC’s Centers for Excellence in Prevention Research, is working with a community coalition, including departments of health in Hillsborough, Pasco and Pinellas counties, as well as the American Cancer Society, Florida Blue, Humana, Florida Health Care Coalition, H. Lee Moffitt Cancer Center, Premier, Front Porch and Luna to increase screening rate to 80 percent by 2018.
“This is an important public health issue because colorectal cancer is the second leading cancer killer in the U.S. for cancers that affect both men and women,” said Dr. Claudia Parvanta, professor in the Department of Community and Family Health and director of the FPRC. “But, if average risk individuals begin screening at age 50, this deadly disease can be prevented all together, or caught at an early enough stage for full recovery.”
According to Parvanta, early stage colon cancer will have almost no symptoms apart from rectal bleeding, which can be confused with bleeding from other causes, making screening essential.
The FPRC and its community partners are focusing efforts on insured individuals over the age of 50 and uninsured individuals ages 50 to 64 who have a medical provider, such as a federally qualified healthcare center.
According to Tali Schneider, FPRC program administrator, these populations are amenable to behavior change and are situated to make those behavior changes possible.
The FPRC and partners have conducted a literature review and interviews with key stakeholders such as insurance providers, employers, and other stakeholders.
They have also implemented group model building activities with the community coalition, as well as American Cancer Society experts, to develop a system dynamics model of the CRCS system. Through these activities, the community coalition and key partners have been able to identify key leverage points that have the most impact towards increasing CRCS.
A review of clinical trials and interventions designed to promote CRCS rates have also been analyzed for successful intervention strategies.
They found that several successful components led to increased CRCS uptake including the provision of access to CRCS, some level of personalization in the intervention strategy and being multi-component in design.
The results of this research inform a computer simulated model of the CRCS system, according to Schneider.
This system model is helping to develop a comprehensive plan for intervening at critical leverage points in that system to boost CRCS.
The FPRC continues to refine this model with the input of the coalition, as well as identify partners with whom to implement and evaluate the emerging intervention plan.
According to Schneider, based on findings to date, potential interventions would address employee wellness programs and free, sliding fee clinics.
The FPRC is still examining the details and designing a marketing plan for a multi-level intervention, which they hope to see implemented across the state in the future.
Parvanta recommends that if an individual does not have a first or second degree relative, such as a parent, sibling, or grandparent, with colon cancer one can safely begin screening at age 50.
Screenings can be done via a fecal immunological test (FIT) or stool blood test, completed annually, or via a colonoscopy every ten years.
“If you have any close relatives with colon cancer, then it’s probably never too early to ask your primary care physician about when to start screening,” Parvanta said. “A doctor I know once said, ‘A colonoscopy is a cure waiting to happen.’”
Story by Aria Walsh-Felz and Anna Mayor, USF College of Public Health