Kentucky Colon Cancer Screening

Program(KRS 215.540-215.544)

PHN ITVApril 18, 2013

Connie Gayle White, MD, MS, FACOGDeputy Commissioner, KDPH

Division Director, DPQI

Why have a screening program?

* Colon Cancer is the third most common cancer diagnosed in both men and women in the US

* Colon Cancer is the second leading cause of cancer death in men in Kentucky

* Colon Cancer is the third leading cause of cancer death in women in Kentucky

* Colon Cancer is >90% preventable if precancerous polyps are removed

US Rate: 46.30

US Rate: 16.70

Agency Representative Agency Representative

American Cancer Society Ellen Schroeder VA Medical CenterJ. Mel Bennett, MD Chair

Colon Cancer Prevention Project William Beam

Kentucky Department for Public Health Connie Gayle White, MD, MS

Colon Cancer Prevention Project Whitney Jones, MD Kentucky Hospital Association Kim DeesColon Cancer Prevention Project Andrea Shepherd

Kentucky House of Representatives Rep. Rocky Adkins

Kentucky African Americans Against Cancer Virginia Bradford, RN

Kentucky House of Representatives Rep. Tom Burch

Kentucky Cancer Consortium Jennifer Redmond, DrPH Kentucky Senate Sen. Alice Forgy Kerr

Kentucky Cancer Program Debra Armstrong, MSW, MPA Kinkead & Stilz, PLLC Benjamin Kessinger, III

Kentucky Cancer Program Connie Sorrel Pike County Health Department Paul Hopkins

Kentucky Cancer Registry Tom Tucker, PhD, MPH UK Markey Cancer Center Mark Evers, MDKentucky Department for Medicaid Services Mary Coleman, RN UL Brown Cancer Center Donald Miller, MD, PhD

Colon Cancer Screening Advisory Committee (KRS

214.544)

Colorectal Cancer Screening in Kentucky70%

60%

50%

40%

30%2002 2004 2006

58.6%

47.2%43.9%

34.7%

20081999 2010

63.7%63.7%

49th in the U.S. 20th in the U.S.

Funding:* KRS 215.540-215.544* Legislature assigned $1 million this biennium (FY

13 – FY 14)* This money will be matched (another $1 million)

by the Kentucky Cancer Foundation, a private organization

* 10 sites received funding for this project

Target Population: Low income uninsured adults aged 50 to 64 Increase colon cancer screening Reduce morbidity and mortality from colon cancer Reduce the cost of treating colon cancer through

screening and early detection Screening Services (annual)

1,500 FIT Screenings 150 Colonoscopies following a positive FIT 500 Colonoscopies for those at increased risk for

CRC

Program Objectives

Target Population: Low income uninsured adults aged 50 to 64 Increase colon cancer screening Reduce morbidity and mortality from colon cancer Reduce the cost of treating colon cancer through

screening and early detection Screening Services (annual)

1,500 FIT Screenings + 1,500 FIT screens donated by Metro LOU

150 Colonoscopies following a positive FIT 500 Colonoscopies for those at increased risk for CRC Plus 150 Colonoscopies donated by Metro LOU

Program Objectives

Development and Release of RFP Review and Scoring of proposals

Development of program policies, manual, and forms

Contracted for lease of FIT analyzer Programming of state lab data system for data

collection Provided 6 face to face trainings for patient

navigators 10 initial site visits conducted – visits continue

throughout the grant period

Tasks Accomplished to Launch the Program

Counties Funded for the Kentucky Colon Cancer Screening Program:

2012-2014

10 Funded CRC Screening Sites* Note – Counties of the same color are funded as

one site** Counties with a starburst are the fiscal agent

for multiple counties not part of a health department district

10 Funded CRC Screening Sites Plus Counties with Coal Severance Funds

Counties Funded for the Kentucky Colon Cancer Screening Program:

2012 - 2014

Counties Receiving Coal Severance Funds

Positive FIT screeningor High risk by history

Positive FIT screening would lead to colonoscopyor High risk by history

Outcome and Quality Control Reports

# and % Positive FIT # and % Defined as

Increased or High Risk # and % Positive Scope Complications on Scope Cecum Reached and

Entered – Target 95% Quality of Prep – Target

90% Good or Excellent

# and % with Polyps # and % with 1cm or

larger polyps # and % needing

surgical resection # and % lost to follow-up Documentation of

connection to cancer treatment

% with Positive FIT where colonoscopy occurs within 90 days – Target 95%

Data of colonoscopy results: first 2 months

●25 colonoscopies ages 30 to 64●7 with family history of colon cancer●3 with personal history of colon polyp

removal●14 negative colonoscopies●9 polyps – 5 adenomatous polyps●1 cancer

April 9, 2013

Thank you to all the partners who have made this program

possible!

Colon cancer awareness

IT’S NOT JUST FOR MARCH ANYMOREIT’S NOT JUST FOR MARCH ANYMORE

Stephanie Mayfield Gibson, MD – Commissioner Director, Division of Kentucky State Laboratory

Connie Gayle White, MD, MS – Deputy Commissioner Director, Division of Prevention and Quality

Improvement Gary L. Kupchinsky, MA - Assistant Director Sue Thomas-Cox, RN, BA, MAC – Branch Manager

Chronic Disease Prevention* Janet Luttrell – Colon Cancer Program Coordinator Becki Thompson, RN, BSN, CDE - Nurse Consultant Teri Wood, PhD - Epidemiologist, Data Management

and Outcome Reporting

Kentucky Department for Public Health Staff