191377 Maryland's Colorectal Cancer Public Health Screening Program

Monday, October 27, 2008: 12:30 PM

Diane M. Dwyer, MD , Medical Director Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Eileen K. Steinberger, MD MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Carmela Groves, RN MS , Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Annette Hopkins, RN MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Barbara Andrews , Center for Cancer Surveillance and Control, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Eithne Keelaghan, MD MS , Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Baltimore, MD
Objective: To evaluate the first eight years of Maryland's public health colorectal cancer (CRC) screening program funded in 22 counties with Cigarette Restitution Funds.

Methods: Local health programs submit data to a central database of client screenings. We analyzed program outcomes from this database.

Results: Of 16,143 people screened for CRC by any method, 7,863 (49%) were minority race or ethnicity; 11,071 (69%) were women. Of 8,316 guaiac-based FOBTs, 7% were positive. For those who were un- or under-insured and low income (usually <250% FPG), and with and without symptoms or family history, the program paid for 146 sigmoidoscopies and 12,729 colonoscopies. On the colonoscopies, CRC was diagnosed on 146 (1.1%), high grade dysplasia on 50 (0.4%), and other adenoma(s) were found on 2,787 (22%).

Conclusion: With sufficient resources, a public health program for CRC screening can be acceptable and successful. Colonoscopy in our underserved population both diagnosed cancers and prevented CRC through polypectomy. Challenges include getting men into screening, and managing and paying for cancer treatment and for complications.

Learning Objectives:
1. List two goals of the Maryland Cancer Program 2. List three organizing principles of the Maryland statewide program 3. Describe the main outcomes of the Maryland program

Keywords: Cancer Screening, Cancer

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Medical Director of the Center for Cancer Surveillance and Control
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: State and local programs to address disparities in colorectal cancer (CRC)
See more of: Medical Care