Improving Colorectal Cancer Screening Rates in the Hispanic Population Utilizing Education and Navigation

Abstract

Colorectal cancer is the second leading cause of cancer related death, and the third most common cancer in the United States (Centers for Disease Control and Prevention [CDC], 2017). Despite the evidence that screening reduces morbidity, mortality, and cost of care; nearly one-third of eligible patients has never been screened for colorectal cancer (Syl D. de la Cruz & Sarfaty, 2014). Furthermore, national data shows that the number of unscreened patients nears 50% in the Hispanic population (National Colorectal Cancer Roundtable, 2016). This lack of screening leads to higher morbidity and mortality rates related to colorectal cancer. The purpose of this quality improvement project was to apply evidence-based interventions to improve colorectal cancer screening rates in a rural federally qualified health center with a predominant Hispanic, Spanish speaking population. A review of the literature provided recommendations for multicomponent interventions, described as the implementation of two or more interventions to best improve screening rates (The Community Preventive Services Taskforce, 2017). The interventions in this quality improvement project included 1:1 education to promote patient engagement in combination with patient navigation to overcome barriers to completion of screening. Patient acceptance of screening increased from 38% to 82%, with an increase of nearly 30% in stool-based testing completed compared to the previous year. In combination with the use of pre-visit planning, standing orders for Fecal Immunochemical (FIT) testing; and transparency in sharing data this pilot project was able to show a significant increase in completion of screening rates with the interventions.