Capacticy for Colorectal Cancer Screening in a Rural State

Rural states have lower colorectal cancer [CRC] screening rates than more urban states. This study used selected aspects of the national colorectal capacity study [SECAP2] to evaluate capacity for CRC screening. Results from this study can be used to improve CRC screening.

A modified SECAP2 measured CRC capacity and quality in a rural state. A list of healthcare facilities was compiled and eligible facilities were contacted to determine willingness to participate. Facilities were telephoned, e-mailed, and surveys were mailed to participating facilities. Telephone calls were completed by trained research assistants. Of 179 surveys, 87 were returned indicating willingness to participate (48.6%). Data was analyzed with IBM Statistical Package for the Social Sciences Version 21.0 (2013) and stored on a secure password-proteced server. The dataset was not linked to healthcare facilities.

Most participants were family practice clinics (n=47). The digital rectal exam [DRE] specimen and/or the guaiac-based 3-card fecal occult blood test was offered by almost two-thirds of the facilities. Fifty-one percent of the facilities offered fecal immunochemical testing.

Colonoscopies were the most frequently performed screening method (56%) followed by the guaiac of a DRE sample (25%). Five percent of facilities had written CRC screening guidelines. Adenoma detection rates (ADRs) were calculated by 33% of colonoscopy performing facilities. Most facilities (71%) did not report to a quality registry.

Education is needed about the recommended clinical practice guidelines for CRC. Development and dissemination of screening protocol is also needed. Innovative approaches to educate the SD populace about CRC screening would be beneficial. Further education about quality measures and quality registries is recommended.