Implementation and Evaluation of a Large Community-Based Colorectal Cancer Screening Program.

Area of Science:

• Public Health
• Cancer Prevention
• Health Disparities

Background:

• Colorectal cancer (CRC) screening significantly reduces incidence and mortality, but screening rates remain suboptimal, particularly among uninsured and those without a usual care source.
• Addressing screening disparities is crucial for improving population health outcomes in cancer prevention.

Purpose of the Study:

• To describe the implementation and evaluation of a community-based CRC screening program (2012-2015).
• To increase CRC screening in a predominantly Hispanic population along the US-Mexico border.

Main Methods:

• A multicomponent, evidence-based program involving bilingual, culturally tailored health education by community health workers.
• Provided no-cost stool-based testing, diagnostic colonoscopies, and navigation services.
• Recruited uninsured individuals through clinics and community sites, followed by extensive process and outcome evaluations.

Main Results:

• 8361 eligible individuals were approached, with 74.8% completing screening and 74.6% completing diagnostic testing.
• 14 colorectal cancers were diagnosed; participants were predominantly Hispanic, female, and of low socioeconomic status (mean age 56.8).
• Process evaluation indicated effective implementation, staff training, process compliance, and high patient satisfaction.

Conclusions:

• The population-based program successfully achieved high fecal immunochemical test kit return and colonoscopy completion rates among uninsured individuals.
• Key success factors included tailored interventions, strong community partnerships, CRC screening expertise, and an active community advisory board.
• This program model can enhance CRC screening rates for underserved populations, especially along the US-Mexico border.