Colorectal Cancer Screening: A Collaboration with Public Health and Primary Care to Increase Colorectal Cancer Screening in a Rural North Dakota Community
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Abstract
Colorectal cancer (CRC) is the second leading cause of cancer related deaths in the nation (Centers for Disease Control and Prevention [CDC], 2017a). Recommendations are to screen adults, ages 50-75 years (United States Preventative Services Task Force [USPSTF], 2016). While 64.4% of the population, ages 50-75 years, in North Dakota (ND) are participating in colorectal cancer screening (CRCS), there is a nationwide challenge to increase CRCS to 80% (National Colorectal Cancer Roundtable [NCCR], 2017; North Dakota Comprehensive Cancer Control Program [NDCRC], 2017). The North Dakota Colorectal Cancer Roundtable (NDCCRT) accepted the challenge and recommended four strategies to increase CRCS; this project focused on the implementing FluFIT (fecal immunochemical test) Clinics. The purpose was to increase public awareness through education at FluFIT sites and increase screening rates with possible FIT to participants meeting screening criteria during the 2017-2018 influenza seasons (NCCR, 2017). Potential participants, ages 50-75 years, coming to FluFIT sites for influenza vaccination were provided informational brochures and asked to fill out a survey regarding knowledge and factors impacting CRCS decisions to increase public awareness and aide future planning for improved screening processes through the ND county Public Health Department. Public Health collaborated with a primary care clinic in town to each host the FluFIT sites. The staff involved from both entities included nurses and clerical staff present at FluFIT sites, and health care providers from the Primary Care Clinic to enter orders for FIT screenings and follow-up on results. There were a total of 31 participants. Only five of these participants met criteria for CRCS with FIT testing between all sites, though none were able to complete screening through the FluFIT sites. The number of distributed informational brochures totaled 347. Despite limited participation, the project increased community awareness on CRCS. The results also provided the ND Public Health Department with information on CRCS knowledge and beliefs to impact further research and identify barriers, while also supporting current literature that indicates there are unscreened individuals in ND. This project can assist future projects to merge the gap of the unscreened CRC population, leading to optimal health outcomes.