Reaching 80% Colorectal Screening Rate by 2018

Illinois Rural Health Association August 12-14th, 2015

Caleb M. Nehring American Cancer Society

Tracey SmithSIU School of Medicine

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The State of Colorectal Cancer and Screening

• Colorectal Cancer is preventable , yet it is the third most common cancer and the 2nd deadliest in the United States when women and men are combined.

• Colon cancer incidence rates have dropped 30% in the last 10 years

• However, we still have work to do! Only 62.5% of adults (between 50-75) in Illinois are up-to-date on screening.

• Nationally: In 2014, an estimated 136,830 new cases are expected to occur, with an estimated 50,310 deaths 2

ACS Screening Guideline for Colorectal Cancer

Options for Average Risk Adults aged 50 and older:

Tests That Detect Polyps and Cancer• Flexible sigmoidoscopy every 5 years* • Colonoscopy every 10 years • Double-contrast barium enema every 5 years* • CT colonography (virtual colonoscopy) every 5 years*

Tests That Mainly Find Cancer• Fecal occult blood test (FOBT) every year*,** • Fecal immunochemical test (FIT) every year*,**

The Best Test is the One that Gets Done* Colonoscopy should be done if test results are positive** For FOBT or FIT used as a screening test, the take-home multiple sample method should be used. An FOBT or FIT done during a digital rectal exam in the doctor's office is not adequate for screening

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Colorectal Cancer Screening Prevalence Among Adults (All Races)

Age 50 Years and Older, 2006-2012

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Snapshot of Colorectal Cancer

State Rank (out of 51)

Screening Rate Incidence (per 100,000 people)

Mortality (per 100,000 people)

Illinois 36 62.5% 50.2 18.1

US Average --- 65% 43.9 16.4

Colorectal Cancer Screening Prevalence Among Adults at FQHC’s (All Races)*

*HRSA Data

National

Illinois

CHESI – Cairo, IL

SIHF

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Snapshot of Colorectal Cancer

What is “80% by 18” Campaign? Collective push to eliminate colorectal cancer as a major

public health problem nationwide

•By making a commitment to a cause and working together collectively across all public and private sectors

•Goal of reaching 80% colorectal cancer screening rate (of eligible population) by 2018

•Campaign officially launched in March 2014

• Much more than just a motto or campaign slogan--requires action

•Led by the National Colorectal Cancer Roundtable (NCCRT) • *Over 200 organizations have signed the pledge to date *

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National Colorectal Cancer Roundtable Established by CDC & ACS in 1997

NCCRT Mission: National coalition of public, private, and voluntary organizations whose mission is to advance colorectal cancer control efforts by improving communication, coordination, and collaboration among health agencies, medical-professional organizations, and the public.

NCCRT Membership: Over 70 organizations and academic institutions including: survivor groups, government agencies (CDC, NCI, CMS,

AHRQ, State Health Depts), community health centers, foundations (AARP), State and regional cancer coalitions (Cancer Coalition of South Georgia, etc.), industry leaders (CMS), medical professional societies (American College of Gastroenterology, etc.), health insurers (AHIP, Gateway Health Plan), voluntary health agencies (ACS), Entertainment Industry Foundation

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Why Now? The Rationale for The Goal

1. Several new reports show great progress2. Many newly eligible adults now have health

insurance3. Many financial barriers are gradually being

eliminated4. FQHCs are now reporting colon cancer screening

rates as one of the UDS measures 5. Emphasis on quality screening is accelerating

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Why Now? The Rationale for The Goal

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6. Wealth of expertise and dedicated individuals in place to catalyze a coordinated push

7. The PCMH has embraced cancer screening8. Tools, Resources and Publications9. The PLEDGE10. The Former Assistant Secretary for Health at HHS

recognized this extraordinary public health opportunity

Who are the 80by18 pledge partners?

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80by18 Pledge PartnersA Few National Partners….

AAFP Indian Health ServicesAGA Indiana State Health DeptAnthem Foundation Jay Monaham Center CDC Kaiser PermanenteC-Change Mississippi Baptist Medical CtrBlue Shield of California Mayo Clinic Cancer CtrColon Cancer Alliance NACHCCommission on Cancer Quest DiagnosticsGreat Plains Tribal Chairman Health BoardGateway Health Plan PolymedcoExact Sciences West Virginia Gov. Earl Ray TomblinEntertainment Industry Foundation Stand Up To CancerDuke Cancer Institute VA Medical CenterHonorable Donald M. Payne (NJ) WalgreensHealth Centers Network of New York North Carolina Dept of HHS

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80by18 Pledge PartnersIllinois Health Systems

•Illinois Cancer Partnership-IDPH•IL Primary Healthcare Association•Blue Cross Blue Shield of Illinois•Blessings Hospital (Quincy)•Presence St. Joseph (Joliet)•SIU School of Medicine (Springfield)•Quincy Family Medicine•Rural Health Incorporated (Anna)•Advocate Christ Medical Center (Oak Lawn)•Ingalls Memorial (Harvey)•Edwards Hospital (Naperville)•Elmhurst Memorial Healthcare •Unity Point Health

– Methodist Proctor (Peoria)– Trinity (Quad Cities)

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80by18 Pledge PartnersIllinois Health Systems Cont.

Signing Soon…..

• Community Health Partnership of Illinois (FQHC)• Chicago Department of Public Health• Central Illinois Endoscopy Center (Peoria)• Advocate Sherman Hospital (Elgin)• KishHealth Hospital System (DeKalb)

And many more……

Strategies & Tools For Health Systems to improve screening rates

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Typically through two tracks:-Provider Education and/or-Patient/Member Intervention(s)

Overall campaign message:-Importance of patient choice in screening

*The best test is the one that gets done*

-NCCRT/ACS Tools, interventions, and technical assistance available to increase CRC in your practice.

Supporting Health Systems; From pledge into action

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ACS Market Research: How To Reach & Message The Unscreened

http://nccrt.org/tools/80-percent-by-2018/80-by-2018-communications-guidebook/

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Toolkit: 80% by 2018 Communication Guidebook

ACS Market Research: How To Reach & Message The Unscreened

Top 4 Best Tested Messages:

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Members:Birthday card with time to get screened messageMessaging in member newsletter on ACS patient resources and screeningHOLD phone messaging on prevention & early detection

Providers:CRC tools shared with network providersTransparency project- scorecards to provider and public sharing screening data by provider compared to state and individual populationsCo-branded script pads for providersIncentive payment structure for screening more patients for cancerPromotion and incentive structure for medical home

Case Management:Implementation of ACS Clinician Portal for oncology population for ACS referral to servicesShare ACS patient navigation program services at internal case manager staff trainings/annual conferences*

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ACS & Health Plan Collaborations

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• Discussions with Chicago Dept of Public HealthCity of Chicago Colorectal Roundtable

• Southern Illinois Colorectal Cancer Collaborative (SICCC)

ACS, ICP, and CDC are working with HSIDN to address CRC cancer “hotspots” – event planned for fall 2015

• Central Illinois Colorectal Cancer Collaborative (CICCC)

SIU SOM and ACS worked together to develop a plan to implement 80x18 in central IL. Activities underway at SIU Center for Family Medicine (Carbondale, Decatur, Springfield, and Quincy sites), Simmons Cancer Institute, and SIU SOM.

Current projects underway

In conclusion

Work with your health system to be part of “80by18” and sign the Pledge

Achieving 80% is possible and will require appropriate use of colonoscopy alternatives

Check out materials on the NCCRT website under tools & resources

Contact an ACS staff partner for more information on the pledge, and how to implement a plan to achieve 80x18

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Best Practices• Evansville, IN

• Deaconess Hospital• ECHO

• SIU Center for Family Medicine• 80 by 18• Flu-FIT

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Questions ?

THANK YOU

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