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Improved CRC screening results, challenges to reach Alaska Natives

Alaska Native Americans have a much higher rate of both colorectal cancer and resulting deaths than other populations—about twice those of the U.S. white population (age-adjusted) for the period of 2004 to 2008. They also have the highest rate of CRC cases of all Native American groups—nearly five times higher than American Indians living in the Southwest, for example.

The reasons? Unknown. But health officials do know that improved screening can prevent CRC, and earlier CRC detection saves lives. And in fact, statewide screening rates among Alaskan Natives improved from 29 percent in 2000, to 41 percent in 2005.

A study in the March 2012 journal Gastrointestinal Endoscopy described pilot projects conducted from 2005 to 2010 designed to increase CRC screening in rural and remote Alaskan Native populations.

Projects included training rural mid-level practitioners in flexible sigmoidoscopy; sending an endoscopist to remote areas to conduct CRC screening at three regional hospitals; creation and use of a CRC first-degree relative database to find and screen people at heightened risk; and training patient navigators to help guide patients through the screening and track results to ensure complete followup of positive results.

From 2005 to 2010, the Alaskan Native screening rate rose from 41 percent to 55 percent, with improved outreach to average-risk and increased risk rural families. However, the study also identified remaining challenges—geography; a limited capacity in the healthcare system; high staff turnover; and difficulty getting patients to screening appointments.

Source: American Society for Gastrointestinal Endoscopy, “Reducing Colorectal Cancer Disparities in Alaska Native Population,” March 2012 Gastrointestinal Endoscopy (a special issue devoted to CRC).

Take-away lesson: Awareness of a huge disparity in cases and deaths, along with initial planning to improve screening was, in itself, associated with a large improvement in screening a rural, at-risk population. But despite using multi-prong approaches to overcome geography and lack of health care access, more work is needed. It’s not good enough to screen just over half of a population that gets and dies from CRC at so much higher rates.

 

 

Improved CRC screening results, challenges to reach Alaska Natives

 

Alaska Native Americans have a much higher rate of both colorectal cancer and resulting deaths than other populations—about twice those of the U.S. white population (age-adjusted) for the period of 2004 to 2008. They also have the highest rate of CRC cases of all Native American groups—nearly five times higher than American Indians living in the Southwest, for example.

The reasons? Unknown. But health officials do know that improved screening can prevent CRC, and earlier CRC detection saves lives. And in fact, statewide screening rates among Alaskan Natives improved from 29 percent in 2000, to 41 percent in 2005.

A study in the March 2012 journal Gastrointestinal Endoscopy described pilot projects conducted from 2005 to 2010 designed to increase CRC screening in rural and remote Alaskan Native populations.

Projects included training rural mid-level practitioners in flexible sigmoidoscopy; sending an endoscopist to remote areas to conduct CRC screening at three regional hospitals; creation and use of a CRC first-degree relative database to find and screen people at heightened risk; and training patient navigators to help guide patients through the screening and track results to ensure complete followup of positive results.

From 2005 to 2010, the Alaskan Native screening rate rose from 41 percent to 55 percent, with improved outreach to average-risk and increased risk rural families. However, the study also identified remaining challenges—geography; a limited capacity in the healthcare system; high staff turnover; and difficulty getting patients to screening appointments.

Source: American Society for Gastrointestinal Endoscopy, “Reducing Colorectal Cancer Disparities in Alaska Native Population,” March 2012 Gastrointestinal Endoscopy (a special issue devoted to CRC).

Take-away lesson: Awareness of a huge disparity in cases and deaths, along with initial planning to improve screening was, in itself, associated with a large improvement in screening a rural, at-risk population. But despite using multi-prong approaches to overcome geography and lack of health care access, more work is needed. It’s not good enough to screen just over half of a population that gets and dies from CRC at so much higher rates.

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