Colorectal Cancer in Appalachia: Understanding the Burden through Community-based Initiatives...
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Understanding the Burden through Community-based Initiatives Presented by the Presented by the Meigs County Cancer Meigs County Cancer Initiative, Inc. Initiative, Inc. Doretta Thomas, CHW Doretta Thomas, CHW Angela Carter Angela Carter Melissa Thomas Melissa Thomas
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Transcript of Colorectal Cancer in Appalachia: Understanding the Burden through Community-based Initiatives...
Colorectal Cancer in Appalachia: Understanding
the Burden through Community-based
Initiatives
Presented by thePresented by the
Meigs County Cancer Meigs County Cancer Initiative, Inc.Initiative, Inc.
Doretta Thomas, CHWDoretta Thomas, CHW
Angela CarterAngela Carter
Melissa ThomasMelissa Thomas
Coalition BackgroundCoalition Background
The Mission of MCCIThe Mission of MCCI
The Meigs County Cancer Initiative The Meigs County Cancer Initiative (MCCI) began as a result of the high (MCCI) began as a result of the high
incidence and mortality rates of incidence and mortality rates of certain cancers in the Appalachia certain cancers in the Appalachia
region of the country. MCCI focuses region of the country. MCCI focuses on increasing awareness, providing on increasing awareness, providing
education, and promoting early education, and promoting early detection and prevention of cancer in detection and prevention of cancer in
Meigs County, Ohio.Meigs County, Ohio.
AcknowledgementsAcknowledgements
Diana Coates, ChairDiana Coates, Chair
Carol Adams, TreasurerCarol Adams, Treasurer
Becky BaerBecky Baer
Lenora LeifheitLenora Leifheit
Melissa ThomasMelissa Thomas
Steve FergusonSteve Ferguson
All All CancersCancers
Lung Lung CancerCancer
ColorectaColorectall
CancerCancer# of # of
Cases Cases in in
19991999
RateRate# of # of
Cases Cases in in
19991999
RateRate# of # of
Cases Cases in in
19991999
RateRate
State of State of OhioOhio
53,253,26666
462.462.99
8,758,7577
75.475.4 6,666,6688
57.857.8
Meigs Meigs CountyCounty
**
119119 458.458.66
2626 98.098.0 1313 48.348.3
MEIGS COUNTY CANCER INCIDENCE RATES
Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002.
Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
*=Data did not meet the standard of 90% complete for 1999 for this county.
The Burden of The Burden of CancerCancer
All All CancersCancers
Female Female BreastBreastCancerCancer
ProstateProstateCancerCancer
# of # of Cases Cases
in in 19991999
RateRate# of # of
Cases Cases in in
19991999
RateRate# of # of
Cases Cases in in
19991999
RateRate
State of State of OhioOhio
53,253,26666
462.462.99
8,228,2222
130.130.99
6,946,9433
139.139.33
Meigs Meigs County*County*
119119 458.458.66
1212 85.085.0 1616 138.138.99
MEIGS COUNTY CANCER INCIDENCE RATES
Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002.
Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
*=Data did not meet the standard of 90% complete for 1999 for this county.
The Burden of The Burden of Cancer Cancer (cont.)(cont.)
274.0 97.5 27.3
24.664.0219.1
29103288Meigs County
11,30729,742101,099State of Ohio
Rate# of Cases
in 1999Rate# of Cases
in 1999Rate# of Cases
in 1999
ColorectalCancer
LungCancer
All Cancers
MEIGS COUNTY CANCER MORTALITY RATES
Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002.
Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
The Burden of The Burden of Cancer Cancer (cont.)(cont.)
274.0 31.0 25.3
34.830.9219.1
1117288Meigs County
5,8278,067101,099State of Ohio
Rate# of Cases
in 1999Rate# of Cases
in 1999Rate# of Cases
in 1999
ProstateCancer
Female BreastCancer
All Cancers
MEIGS COUNTY CANCER MORTALITY RATES
Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002.
Average annual rate per 100,000, age-adjusted to the 2000 US standard population.
The Burden of The Burden of Cancer Cancer (cont.)(cont.)
About Our StudyAbout Our Study• Conducted in December 2000Conducted in December 2000• Survey collection sites: local grocery Survey collection sites: local grocery
storesstores•Powell’s Super Value Store Powell’s Super Value Store •Kroger Kroger •Vaughan’s GroceryVaughan’s Grocery•FoodlandFoodland•PamidaPamida
• Collection Period: Two weeksCollection Period: Two weeks– December 4-15December 4-15
Survey DevelopmentSurvey Development
• Adapted from a 10-question online Adapted from a 10-question online survey survey – Developed by Dr. Signey J. Winawer, from Developed by Dr. Signey J. Winawer, from
Memorial Sloan-Kettering Cancer CenterMemorial Sloan-Kettering Cancer Center
• Multiple-Choice FormatMultiple-Choice Format• Included Age, Gender, Address Included Age, Gender, Address
DemographicsDemographics• Incentive—Drawing for $100 held Incentive—Drawing for $100 held
prior to the holidaysprior to the holidays
ResultsResults• 1046 surveys were completed over the two-week 1046 surveys were completed over the two-week
period!period!• After removing duplicates, 1005 surveys After removing duplicates, 1005 surveys
remained.remained.• Key findings:Key findings:
– Underesimated frequency of colorectal cancerUnderesimated frequency of colorectal cancer– Overestimated frequency of colorectal screening Overestimated frequency of colorectal screening
teststests• Thought sigmoidoscopy and colonoscopy were annual testsThought sigmoidoscopy and colonoscopy were annual tests
– Majority of participants thought colorectal Majority of participants thought colorectal screening tests should begin at age 40screening tests should begin at age 40
Designing the Designing the InterventionIntervention• Goals Goals
– To increase knowledge of colorectal cancerTo increase knowledge of colorectal cancer•Risk FactorsRisk Factors•Screening GuidelinesScreening Guidelines
– To increase compliance of colorectal cancer To increase compliance of colorectal cancer screening guidelinesscreening guidelines
– To increase awareness of local resources for To increase awareness of local resources for colorectal cancer screeningscolorectal cancer screenings•Medicare for individuals over 60 years of ageMedicare for individuals over 60 years of age•Local clinics/hospitals who provide colorectal cancer Local clinics/hospitals who provide colorectal cancer
teststests
Designing the Designing the Intervention Intervention (cont.)(cont.)
• The method: brochure testingThe method: brochure testing– NCI brochure on colorectal cancerNCI brochure on colorectal cancer– NCI brochure targeted toward Medicare-NCI brochure targeted toward Medicare-
age individualsage individuals
– MCCI-developed brochure that MCCI-developed brochure that targeted weak knowledge areastargeted weak knowledge areas•Screening test definitionsScreening test definitions•Screening guidelinesScreening guidelines•Risk factorsRisk factors
Designing the Designing the Intervention Intervention (cont.)(cont.)
2000 MCCI Colorectal
Cancer SurveyParticipants Age
59 and Under(P1)
Control Group 1
(C1)
Target Group 1
(T1)
Target Group 2
(T2)
Participants Age 60 and Over
(P2)
Control Group 2
(C2)
Target Group 3
(T3)
Target Group 4
(T4)
2000 MCCI Colorectal Cancer Survey
Participants Age 59 and Under
(P1)
Control Group 1
(C1)
Target Group 1
(T1)
Target Group 2
(T2)
Participants Age 60 and Over(P2)
Control Group 2
(C2)
Target Group 3
(T3)
Target Group 4
(T4)
The ProcessThe Process
• Mailed brochures/letters to all Mailed brochures/letters to all intervention groups on 9/1/03.intervention groups on 9/1/03.
• Six-month delay until T2 survey Six-month delay until T2 survey is mailed.is mailed.– Awaiting results of T2 surveyAwaiting results of T2 survey
• Have reported findings in Have reported findings in community meeting forum.community meeting forum.
Final Thoughts…Final Thoughts…
• Completely community-basedCompletely community-based– Partnered with local agencies and ACN to Partnered with local agencies and ACN to
maximize resources and reduce costmaximize resources and reduce cost
• Simple research design Simple research design – Wanted to test the effectiveness of brochures for Wanted to test the effectiveness of brochures for
information disseminationinformation dissemination– Developed original brochure that targeted key Developed original brochure that targeted key
knowledge areas knowledge areas
• Results will be published in public Results will be published in public health journalshealth journals
Contact InformationContact Information
Meigs County Cancer Initiative, Inc.Meigs County Cancer Initiative, Inc.PO Box 85PO Box 85
Pomeroy, OH 45769Pomeroy, OH 45769
Phone: 740-992-2161 (Diana Phone: 740-992-2161 (Diana Coates)Coates)
614-544-5287 (Melissa Thomas)614-544-5287 (Melissa Thomas)Email: [email protected]: [email protected]
