NC Partnership to Increase Colorectal Cancer Screening - The mission of the North Carolina Department of Health and Human Services (DHHS) is to collaborate with partners and provide essential services to improve the health, safety, and well-being of all North Carolinians. To advance the mission of DHHS through colorectal cancer screenings, the North Carolina Partnership to Increase Colorectal Cancer Screenings (NC PICCS) will support collaborations between health systems, the NC Division of Public Health, the American Cancer Society, and the University of North Carolina at Chapel Hill University to implement evidence-based interventions for people aged 45-75 to increase colorectal cancer (CRC) screenings rates and follow-up colonoscopies at participating NC PICCS clinics. In 2022, colorectal cancer (CRC) was the fourth most frequently diagnosed cancer and fourth leading cause of cancer death in North Carolina (NC Central Cancer Registry). While CRC mortality rates have decreased from 14.8 per 100,000 in 2008-2012 to 12.7 per 100,000 between 2018-2022, the state still falls short of the Healthy People 2030 target of 8.9 per 100,000 (NC State Center for Health Statistics and National Health Interview Survey). CRC screening rates are low (44.64%) among nearly 695,000 patients served by NC’s 42 federally qualified health centers (FQHC). CRC screening is significantly underutilized among vulnerable populations, with younger people experiencing rising rates of both CRC incidence and mortality. NC PICCS will work with health systems to implement evidence-based interventions such as implementing patient screening reminders, provider reminders and feedback, supporting patients with patient navigation and reducing structural barriers helps to prevent CRC and decrease late-state CRC diagnosis. The NC PICCS team and partnering clinics are hoping to achieve several critical outcomes through the program’s efforts. In the short term, there is increased implementation and enhancement of EBIs in partner clinics, leading to improved CRC screening rates, higher prevalence of stool-based test returns and colonoscopy completion. Clinics are also building greater awareness and capacity for QI initiatives, fostering better engagement with GI practices, and strengthening continuity of care across the cancer continuum, from screening to treatment to survivorship. Intermediate outcomes include an increase in CRC prevented and will see a significant improvement in the processes for CRC screening and follow-up colonoscopy systems. In the long term, these efforts will contribute to a decreased CRC incidence and mortality, the sustainability of QI practices and EBI implementation, and meaningful policy and system-level changes that support enduring health improvements. By supporting FQHCs in improving colorectal cancer (CRC) screening processes and overcoming screening barriers through connections to community resources, health systems will be better prepared to implement sustainable, multi-component evidence-based interventions. These efforts will address challenges to timely CRC screening and colonoscopy completion, ultimately helping to lower CRC incidence and mortality rates in North Carolina.
