Colorectal Cancer in Mississippi: How to Change the Tide of Bad News to a Success Story?

Colorectal cancer (CRC) remains one of the most preventable yet deadly cancers in the United States (MS), with Mississippi reporting the highest CRC incidence and mortality rates nationally. More importantly, this is largely attributed to late-stage diagnoses, which are more difficult and expensive to treat. Despite the proven effectiveness of CRC screening (CRCS) in early detection and prevention, screening uptake remains low in MS, particularly among socioeconomically disadvantaged and rural populations. Public health challenges in MS are compounded by a high poverty rate, low educational attainment, high uninsured rates, and widespread provider shortages. Factors such as distance to basic healthcare services and underserved medical facilities create structural barriers that limit access to cancer prevention services, leading to delayed diagnoses and increased mortality. Additionally, MS has one of the lowest physician-to-population ratios in the United States, making it difficult to expand traditional provider-based screening programs. To address these disparities, this review proposes a multi-level, precision population health strategy tailored to the state's needs. The model integrates the Chronic Care Model (CCM), community health workers (CHWs), telehealth hubs, team-based care, and community education to expand CRCS access and effectiveness. CHWs, as trusted community liaisons, are uniquely positioned to bridge gaps in awareness, navigation, and follow-up. By training CHWs to support test selection, assist with test administration, and coordinate referrals and follow-up care, this model enhances outreach and engagement in underserved areas. Further, we recommend the application of key social determinants of health (SDH) indices such as the Area Deprivation Index (ADI), Social Deprivation Index (SDI), and Life Expectancy Index (LSI), to target high-risk populations. These composite indices help identify locations with the greatest need for intervention and resource allocation. When combined with emerging innovations in precision medicine, such as non-invasive tests and digital tracking tools, CRCS efforts can be made more efficient, scalable, and equitable. In summary, this review outlines a comprehensive, data-driven strategy for improving CRCS uptake in MS, with broader implications for other Deep South states facing similar challenges. By delivering the right screening test to the right person at the right time, this approach not only supports early detection and reduces mortality but also contributes to long-term health disparity elimination and system-level transformation in cancer prevention and care.