Increasing Colorectal Cancer Screening in Iowa Using Evidence-based Interventions - Iowa has the second highest cancer incidence rate in the US and is one of only two states with a rising incidence rate. According to the Iowa Cancer Registry’s 2024 Cancer in Iowa report, approximately 1,660 new cases of colorectal cancer (CRC) will be diagnosed in Iowa and 550 Iowans will die per year from the disease, making CRC the second leading cause of cancer deaths. Iowa has a higher CRC incidence rate, 39.1 per 100,000, compared to the national rate of 36.5 per 100,000, making Iowa the 11th highest state for CRC incidence. The Iowa Department of Health and Human Services (Iowa HHS) is applying for Changing Health Systems Using Evidence-based Interventions to Increase Colorectal Cancer Screening CDC-RFA-DP-25-0012 to address Iowa’s growing CRC incidence and mortality rates by increasing screening among adults aged 45 to 75 years at Iowa’s Federally Qualified Health Centers (FQHCs). Iowa HHS has over 10 years of experience establishing relationships and successful partnerships with the Iowa Primary Care Association and the FQHCs it represents. Iowa HHS will collaborate and assist FQHC primary care clinics in implementing and evaluating evidence-based interventions (EBIs) that increase CRC screening. This application’s focus will provide access to CRC screening for underserved Iowans in the geographic service areas of four Iowa FQHCs. These FQHC partners are: All Care Health Center, Community Health Center of Fort Dodge, Infinity Health and Primary Health Care, Inc. Combined, the four FQHCs have a 32% CRC screening prevalence. Iowa HHS will provide guidance and collaboration to FQHCs in administering the CRC screening Readiness Assessment and Implementation Plan with support from Iowa PCA. Each FQHC will identify and select at least three EBIs. EBIs will be multi-component, focusing on different areas of the clinical environment. Iowa HHS will increase the number of screening tests provided and completed, as well as the number of people with an abnormal test who are referred to and scheduled for a colonoscopy at participating FQHCs. Iowa HHS will increase the number of funded and reimbursed follow-up colonoscopies for participating FQHCs. Iowa HHS will monitor and evaluate program activities to ensure high quality-data is used to inform future work. Yearly evaluation findings will be used to make program adjustments and apply lessons learned to enhance program activities. Evaluation results will be shared with CDC, the Iowa PCA, health system providers and patients to inform partners about the program’s progress in achieving planned outcomes. Iowa HHS has a solid infrastructure and the capacity to address the strategies, objectives, activities and performances measures to accomplish the program outcomes as required. A detailed work plan for Year 1 and a budget of $900,000 has been prepared.
