Evaluation of the South Carolina's Screening Colonoscopy On People Everywhere (SCOPE) Program for the Uninsured

Background: Screening colonoscopy remains the gold standard public health tool for colorectal cancer prevention. The SCOPESC program was funded by the South Carolina Department of Health and Environmental Control with $1 million to expand screening colonoscopy services to the indigent, consistent with the State Cancer Plan. During Year I, a total of 682 qualifying individuals (income below 200% of federal poverty and no insurance coverage for colonoscopy) were provided the service at 5 provider sites. All providers submitted colonoscopy and pathology report information as a condition of being reimbursed under the program. We present a performance evaluation for Year 1.

Objective: To assist SCOPESC in optimizing its cancer prevention potential by providing an assessment of colonoscopy quality indicators relative to national benchmarks.

Methods: Deviations from nationally accepted quality benchmarks including polyp and adenoma detection rates, and bowel preparation quality were studied, and quality-associated variables identified for potential quality improvement efforts. Analyses include logistic (including multinomial) regression modeling. Analyses include logistic (including multinomial) regression modeling.

Findings: Of 665 persons with data available, 71.1% are female, 70.3% African-American, 56.1% had at least one polyp, and 26.6% at least one adenoma. The sample age, gender, race and geographic distribution relative to polyp and adenoma rates and characteristics will be presented.

Conclusions: Findings are discussed against the backdrop of South Carolina's colorectal cancer incidence and mortality profile, and the potential of SCOPE-SC to reduce colorectal cancer disparities will be discussed, Implications for program expansion to reach a larger indigent population will be discussed.