Reaching rural communities for colorectal cancer (CRC) screening and cancer prevention is critical to closing the gaps in care and addressing health equity. A new study published in the journal Cancer finds that teens and young adults with cancer who live in rural areas or far from the hospital where they were diagnosed are more likely to have advanced cancer and more likely to die.

But how do we reach our rural communities? In July, Fight CRC advisor and University of Colorado Cancer Center faculty member, Andrea “Andi” Dwyer, took us to her hometown in Colorado and shared some of the work she’s doing alongside the Colorado Cancer Coalition to help increase access to CRC screening in rural communities.  

Cheyenne County, where Andi grew up, has the second-highest age-adjusted incidence rate of all cancers in Colorado and is one of the most rural counties in the state. Andi is a seventh-generation Coloradan from a farm ranch family with deep ties to health care delivery and a native of Cheyenne County. Andi’s mom was diagnosed with CRC at age 41.

On July 23, Andi and the Colorado Cancer Coalition leadership went to Cheyenne County to unveil the 2021­–25 Colorado State Cancer Plan in concert with the Communities That Care Community Action Plan. More than 40 Cheyenne County residents joined in person, and nearly 100 more joined virtually. This launch was a big deal as it set the agenda for cancer control for the next five years in Colorado and also engaged the local public health planning committee to illustrate state and local synergy.  One of the Colorado Cancer Coalition's main priorities is to focus on increasing capacity and screening rates in rural and frontier counties. Launching the State Cancer Plan in rural Colorado authentically engages the target community and brings much-needed focus to rural Colorado.

Andi, in her term as Chair of the Colorado Cancer Coalition, helped launch the Colorado Cancer Coalition in Communities Program, which aims to improve cancer outcomes for rural and frontier communities by working with a community to assess its needs and create a collaborative approach to cancer prevention and early detection.

The campaign focuses on:

• Launching the Colorado State Cancer Plan and aligning with public health strategies and efforts in Cheyenne County to increase cancer prevention and control
• Providing support in grant writing and funding proposals for cancer prevention, which will help raise more than $50,000 for support of a new mammography unit and for funding colonoscopies
• Supporting Hospital Week at Keefe Memorial Hospital and county clinic locations to provide preventive screening services and access to CRC screening and skin cancer prevention (the Sun Bus)
• Supporting Cheyenne County Walk for a Cure and helping raise funds for housing and travel expenses for rural patients who are engaged in clinical trials or treatment
• Facilitating the awareness campaign with advocates and survivors for the #EndCancerCheyenne Ambassador Campaign in Cheyenne County

Colorado is approaching these challenges from both a public health and public policy perspective. Colorado is a grantee of Fight CRC’s Catalyst State-by-State Advocacy Program and is working to advance legislation that will help ensure access to care for the medically underserved and eliminate out-of-pocket costs for patients who need colonoscopy screenings following positive noninvasive CRC screening tests.

Partnership is key. Bringing together national partners such as Fight CRC with state-level resources, state cancer coalitions, local public health, and local champions and advocates is critical to increasing CRC screening rates in rural and frontier communities.

Kathy Dwyer Keefe, Andi’s mom, speaking about her diagnosis and what Catch It In Time means to her.