UICC World Cancer Congress 2006

Reduce (or eliminate) the disparity in the colorectal cancer death rates for African Americans: African American males suffer a 40% higher death rate predominately due to advanced stage at detection. In 2005, there are only 41 African Americans of the over 1,000 physicians in the three year fellowship training for gastroenterology – less than 14 per year. We aim to reduce barriers to screening in our community.

Methods:

We address both the supply and demand components of the equation: We have a highly structured training program which has produced 17 African American graduates who now perform screening colonoscopies. The details of the training are addressed elsewhere. The training is coupled with an aggressive community outreach program incorporating Federal Health Centers and a faith based initiative.

Results:

To date, over 5,000 have been screened. Our experience reveals a much higher than previously published polyp detection rate when screening disparaged populations. We believe further dissemination of this model could address both the capacity and the demand of the disparities issue. The revenue per screening exam is considerably below existing norms and, if sustainable, would provide an economically sustainable solution to achieving Health People 2010 goals. We hope to mirror the gains the CDC has made in cervical cancer in programs such as South Carolina's Best Chance Network- but for colonoscopy screening for colorectal cancer. We have generated a ground swell of demand through outreach and met the demand with innovative means of training community oriented physician providers.