Implementation of a Colorectal Cancer Screening Program in a Rural Upper Midwest Federally Funded Health Center: An Evidence Based Project
One of the many goals developed by the United States Government in its Healthy People 2020 campaign was to “reduce the number of new cancer cases, as well as the illness, disability, and death caused by cancer” (Healthy People 2020, 2016). This goal is further broken down by cancer types. The goals for colorectal cancer (CRC) is to reduce the 2007 baseline mortality rate of 17.1 deaths per 100,000 to 14.5 deaths per 100,000 and to increase the proportion of adults to receive colorectal cancer screening (CRCS) based on the most recent guidelines by the year 2020. The American Cancer Society (ACS,
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NCHC’s CRC rates (22%) are below North Dakota’s established rate of screening. The purpose of this Doctorate of Nursing Practice Project will be to establish an evidenced based colorectal cancer screening and surveillance initiative to help improve CRC rates.
Identify the problem CRC screening rates have been improving since Healthy People 2010, however the rates in North Dakota are still significantly lower than the goal proposed by Healthy People 2020. The ACS (2014a) has released a document revealing the most recent facts and figures regarding CRC screening rates, diagnoses, risk factors, and treatment in the United States. These data are most recent as of 2012. CRC screening prevalence in North Dakota (ND) for those age 50 years and older was 57.9%, ranking ND in the lower tertile bracket of states in the U.S., and below the national average (CDC, 2013). This rate, with Washington D.C. included, ranked ND at 42 out of 51 states. Healthy People 2020 (2016) hopes to increase the national CRC screening rate to greater than 70% for all people age 50 years and older by the year 2020. There has been an identified need at NCHC, a federally qualified community health center, located in North Dakota, to improve CRC screening rates and surveillance within its healthcare system. Based on results from quality measure
The DNP project’s results will be disseminated, not only to the University of Mary and the project leaders’ peers; but to the host organization, its Board of Directors, Administration, and direct-patient-care employees. The project leaders intend on further disseminating the project and its results by submitting an abstract to a scholarly journal. The project demonstrated improved optimization of the organization’s EMR, improved understanding and knowledge regarding CRCS and its necessity within NCHC’s employees, provided more efficient outreach tactics and strategies for contacting the NCHC patient community, and ultimately, provided additional areas of improvement and future direction for NCHC as a whole. The interventions from the DNP project were developed with the intent to continue to provide NCHC strategies to improve in other areas of health maintenance and cancer prevention for the future, thereby enhancing the population being served and promoting improved health
When analyzing the community health assessment several risks and weakness are identified. There are a few risks and weakness with the current state of Oncology Services. With physicians practices already at capacity there is no room to handle the current and future demand for these services. With an aging population new cancer cases are expected to increase by 34 % in five years. Higher smoking rates also contribute to new cancer diagnosis. Another risk is the equipment to diagnose and treat cancer is not keeping up with patient volume. This could be due to antiquated equipment that takes longer to scan patients therefore delaying results and sometimes requiring additional scanning. Additionally, poorly coordination of services by
The North Carolina-Based Breast Cancer Screening Program (NC-BCSP) was questioning if they could increase African-American women’s access to breast cancer screening, would this help women determine their risk factors and seek further screening process? The goal was to decrease the obstructions of the women in North Carolina to everyday health care, but at the same time increase women’s access to breast cancer screening, while making connections that could help women across the state. The evaluated outcomes was to implement an education process so that there was a tracking system that would determine if the participants were at the human health center and clinic for their initial visit or a repeat visitor.
This book is directed to the many professionals in government, academia, public health and health care who need up to date information on the potential for reducing the impact of cancer, including physicians, nurses, epidemiologists, and research scientists. The main aim of the book is to provide a realistic appraisal of the evidence for both cancer prevention and cancer screening. In addition, the book provides an accounting of the extent programs based on available knowledge have impacted populations. Overview of the evidence base for cancer prevention and screening, as demonstrated in Epidemiologic Studies in Cancer Prevention and Screening, is critically important given current debates within the scientific community. Yet the knowledge available to prevent many cancers is incomplete, and even if we know the main causal factors for a cancer, we often lack the understanding to put this knowledge into
African Americans carry an uneven share of the cancer load in the United States, having the highest death rate and shortest survival of any racial or ethnic group for most cancers. In this article, I will provide updated data for African Americans on cancer rate, death, survival, and cancer screening. I also estimate the total number of deaths prevented among African Americans as a result of the decline in cancer death rates since the early 1990s.
The MPHFP enables certain rural hospitals to be licensed as Critical Access Hospitals (CAHs) that receive cost-based reimbursement from Medicare in return for limiting their services (Rural Assistance Center- CAH Frequently Asked Questions, 2012). Under costbased reimbursement, health care providers receive reimbursement based on actual costs incurred which is a more generous reimbursement method than allowed by the prospective payment system (Gapenski L, 2009). However, only those providers that fall under the following categories are eligible to become CAHs: currently participating Medicare hospitals; hospitals that ceased operation after November 29, 1989; or health clinics or centers (as defined by the State) that previously operated as a hospital before being downsized to a health clinic or center (Department of Health and Human Services, 2013). A Medicare participating hospital that wishes to convert to a CAH, has to meet certain criteria including (Department of Health and Human Services, 2013): Be located in a state that has established a State rural health plan for the State Flex Program; Be located in a rural area or be treated as rural under a special provision that allows qualified hospital providers in urban areas to be treated as rural for purposes of
As stated previously in 2014 the USA had approximately 20.3 million people who were diagnosed with cancer. When exploring the 2013 incident rates of men with cancer black men had an incident rate of 518. Compared to white men of 473.9, next came Hispanic and Asian; black males had the highest death rate among all races (Centers for Disease Control and Prevention, 2016b). In regards to women, white women had an incident rate of 417.4, followed by blacks, Hispanics, and Asians, but the highest death rate is among black women (Centers for Disease Control and Prevention, 2016b). According to the statistics the needs for increased screening and care is needed in the African American and Hispanic community.
Early detection, screening and prevention, often times is not provided by mainstream America to support programs that benefit all American’s. Often Minority groups are sometimes five years after preventative screening before tests are available to
However, finding out about a deadly disease on a timely manner outweigh the risk of not knowing. For example, as mentioned before, a close friend name Yvonne died of colorectal cancer couple of years ago. The reason for her death was that she found out too late that she had CRC. Worse, after spending all her life savings, even though she had insurance, she had to listen to the physician telling her the most famous but detrimental words “there is nothing we can do for you at this stage.” With that said, the plan is to use stories like Yvonne’s to persuade all stakeholders that increasing the statistics with the number of survivors is the only and most advantageous option for all. Also, the Health Department can help convince policy makers to provide more funds to sustain such program relying on the fact that early screening can prevent colorectal cancer-related death by finding precancerous polyps, or by discovering CRC early (Center for Disease Control and Prevention, 2011). Early detection of CRC at a less advanced stage is easy to treat; therefore cost effective (Center for Disease Control and Prevention,
Over 1 million people across the country have battled colon cancer and have come out winners. Their survival can squarely be attributed to regular screening and early diagnosis. Here is why-
Colon cancer is a lethal disease and remains one of the leading causes of cancer related deaths in the United States (Williams et al, 2016). Despite the overall decline in colorectal cancer (CRC), African Americans (AAs) continue to lag behind and have a higher prevalence, mortality, and the lowest survival rate among any other racial group (Williams et al., 2016). For this reason, some professional organizations recommend screening for AAs start at the age of 45 rather than age 50 (Jackson, Oman, Patel & Vega, 2016). However, endorsement of earlier screening among AAs alone does not equate to an increase in the uptake of CRC screening.
The NHS have found that bowel cancer is one of the most common cancers in the UK, with around 40,000 new cases being diagnosed every single year. This means that approximately 1 in every 20 people will develop bowel cancer at some point within their lifetime. However, the earlier it is detected, the higher the rate of successful treatment and survival. This is why bowel screening is so important. It has been found that around 90% of those who suffer from bowel cancer are over the age of
Despite the difficulty, researchers have reported the benefits of screening. The most recognized benefit of health screening according to Durojaiye, (2009) is it’s effectiveness in reducing morbidity and mortality from disease by detecting it before symptoms occur. A report in 2006, by the Advisory Committee on Breast Cancer Screening, shows that screening saves 1,400 lives a year in England. In Australia, The age-standardized breast cancer mortality rate in women of all ages declined significantly from 28 per 100,000 women in 1996 to 24 per 100,000 in 2005. Mortality from breast cancer among women aged 50-69 was reported to have declined from 62 deaths per 100,000 in 1996 to 52 deaths per 100,000 in 2005 (Australian Institute of Health and Welfare, 2008) . Evidence also suggests that a reduction in death rates of around 95% is possible in the long-term with cervical cancer screening. The screening of pregnant women to identify and intervene early with risks to their health and that of their babies are associated with improved health status among high-risk populations (Durojaiye, 2009). The idea of screening therefore is to prevent, not to cure. Pope (1992), stats that screening is the second best option, but one which
National Colorectal Cancer Awareness Month is used to bring awareness to one of many cancers that affects 1 in every 100 person, health wise. Although colorectal cancer can be preventable, it is among the list of cancers that affect both men and women. As one of the second leading causes of cancer deaths in the United States, colorectal cancer affects approximately 140,000 Americans who are diagnosed each year, leaving more than 50,000 people die from it. According to the Prevent Cancer Foundation, the list below are ways to prevent this cancer:
Timing of diagnosis is critical in the health outcomes of individuals who have a malignancy. As such, the conduction of a linguistically congruent call outreach program that targets to educate the population at risk regarding the importance of adherence to colorectal screening is a primary preventive strategy that can positively impact the awareness of the population at risk for colorectal cancer (Healthy 2020, 2017).