Increasing Colorectal Cancer Screening in Northeastern North Carolina

Abstract

Colorectal cancer has the 3rd highest prevalence and the 2nd highest mortality rate of all cancer in the United States, with over 4,000 new diagnoses and 1,600 deaths reported in North Carolina yearly. Early detection significantly reduces mortality, however rural patients are less likely to have timely colorectal cancer screening. The objective of this quality improvement project was to increase the number of stool-based colorectal screening kits returned for analysis at a primary care clinic in rural northeastern North Carolina. The initiative involved introducing a new reminder system for colorectal cancer screening to the staff of a rural clinic. All patients 50 and older of average cancer risk who received screening kits during a 10-week period were logged. The patients were called after 2 weeks as a reminder to return the kit if they had not already done so. The clinic providers saw 650 eligible patients and distributed 68 kits during the project period, of which 25 (37%) were returned, as compared to the 3-month period prior to the intervention, in which the providers saw 810 patients and distributed 14 kits, with 7 (50%) returned. The number of test kits both distributed and returned increased substantially despite similar numbers of eligible patients. While some patients may have been motivated by the telephone reminders, the increase may also have been a factor of distributing more kits.