The Southwest Coalition for Colorectal Cancer Screening (SuCCCeS) Program
Introduction
Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. Additionally, people residing in underserved, rural, or border communities in South and West Texas face CRC cancer disparities due to their socioeconomic status, rurality, and racial/ethnic minority status. Although screening is universally endorsed, screening rates remain significantly low in many counties compared to the national target. The SuCCCeS program was initially funded in 2017 and is an expansion of the ACCION program. This successful, evidence-based bilingual comprehensive CRC screening intervention was previously developed with CPRIT support. The program includes outreach, education, no-cost screening and diagnostic services, and patient navigation. In addition, the program combines both a community-based approach and a health-setting-based approach to maximize its impact. ACCION/SuCCCeS program has been implemented uninterrupted for 13 years with outgoing expansion and improvement to maintain program outcomes. The program aims to increase the uptake of CRC screening in 56 West Texas counties and provide culturally relevant CRC education.
Methods
This multilevel and multi-component evidence-based colorectal cancer screening intervention was implemented in the community and expanded to hospital and clinic systems throughout West Texas using dissemination and implementation methods. Eligibility criteria include men/women aged 45-75 years who are uninsured/underinsured, have self-reported Texas addresses, and are due for screening. Education, navigation, no-cost screening fecal immunochemical test, and colonoscopy services are provided. Descriptive statistics were used to describe program uptake.
Results
Since the inception of our program in 2011, 42,144 participants have been enrolled, 39,445 were given a fecal immunochemical test, and 26,773 (67.8%) returned the test; 15,944 were repeat participants, of which 13,587 (85.2%) completed a FIT test; the FIT positive rate was 5.0% (n=1,552). 1859/2693 completed a colonoscopy (69.0%), of which 733 (39.4%) was a screening colonoscopy and 1,104 (59.3%) a diagnostic colonoscopy. 752 patients were diagnosed with adenomatous polyps and 33 with colorectal cancer. All cancer patients were navigated into treatment.
Conclusion
An established CRC screening program can be implemented community-wide and across the healthcare sector to improve CRC screening uptake.