Current Status of Colorectal Cancer Screenings: Tailoring Them to Mississippi's Rural Geography, Demographics,...

Area of Science:

• Oncology
• Public Health
• Health Services Research

Background:

• Colorectal cancer (CRC) is a significant health issue globally, particularly in resource-scarce regions like the Deep South (DS) of the US.
• Low colorectal cancer screening (CRCS) uptake in areas like Mississippi (MS) and DS contributes to poorer patient outcomes.
• Effective CRC prevention hinges on increasing CRCS uptake through appropriate interventions for specific populations.

Purpose of the Study:

• To provide a comprehensive overview of state-of-the-art CRCS options, detailing their advantages and disadvantages.
• To guide practitioners and community health care workers (CHCW) in selecting optimal CRCS strategies for at-risk populations.
• To propose a framework for implementing precision, community-tailored CRCS interventions to improve uptake and outcomes.

Main Methods:

• Literature review of the past decade focusing on CRCS options, cost-effectiveness, and clinical outcomes.
• Synthesis of evidence from international trials and national healthcare systems on tailoring screening practices.
• Analysis of simulation models and population-level studies on 13 different CRCS strategies.
• Inclusion of insights from cluster-randomized trials on integrating CHCW and patient navigation.

Main Results:

• Detailed comparison of various CRCS methods, including invasive visualization, non-invasive visualization, and stool/blood-based tests.
• Evaluation of the cost-effectiveness and clinical outcomes of 13 distinct CRCS strategies.
• Evidence supporting the integration of CHCW and patient navigation to enhance CRCS uptake in rural areas.

Conclusions:

• A one-size-fits-all approach to CRCS is inadequate; tailored, interdisciplinary strategies are essential for improving uptake and outcomes.
• Precision population medicine concepts, including telemedicine and wearable devices, can enhance CRCS delivery.
• Implementation of community-tailored CRCS interventions, emphasizing equity and informed choice, is crucial for high-risk and underserved populations.