UICC World Cancer Congress 2006

Objective: The purpose of this project is to gain a better understanding of how to provide colorectal cancer early detection to those without insurance, through the Michigan Colorectal Cancer Early Detection Pilot Program. The Michigan Cancer Consortium Colorectal Cancer Early Detection Guidelines provide the basis for risk-based screening that will occur in this project. From these risk-stratified screening guidelines, risk assessment tools have been developed.

Methods: According to Pilot Program protocol, a risk assessment will be completed on every eligible client. Risk assessment involves a two step process. Step one is the Self Risk Assessment (SRA) filled out by the client to help determine the type of colorectal cancer screening test to be used. Step two is an Expanded Risk Assessment completed by a health professional; if potential risk factors are identified through the SRA. Average risk clients will receive a fecal occult blood test, while those at increased risk will receive colonoscopy. Clients at increased risk will be identified as possible candidates for genetic counseling.

Results: Risk assessment forms were provided to each pilot site. Completed forms are being submitted monthly and entered into a central database for evaluation and tracking purposes. Outcome evaluation will examine the proportion of average vs. increased risk individuals that were screened, and the need for genetic services. Process evaluation will determine the usability of the risk assessment tools for both clients and staff participating in the project. Preliminary results are expected in May 2006.