Oregon's Application for Changing Health Systems Using Evidence-based Intervention to Increase Colorectal Cancer Screening - Oregon’s overall colorectal cancer (CRC) incidence and mortality rates have decreased by 36% and 39% respectively over the past 30 years, yet CRC is still the fourth most diagnosed cancer in Oregon and the fourth leading cause of cancer death. Those living in rural parts of Oregon, those who are White, American Indian and Alaskan Native (AI/AN), and Black or African American have the highest CRC incidence rate in the state. Further, CRC mortality rates are highest among rural residents and people who are Asian Pacific Islander and Black or African American. CRC screening is the most effective tool available to decrease the burden of colorectal cancer. As with incidence and mortality, screening prevalence rates have improved over the past decades, however, they are much lower in rural areas and among those who are Asian, Hispanic or Latino/a, and AI/AN. The most striking CRC screening disparities lie with those who are uninsured and those who have health insurance coverage through the Oregon Health Plan (Oregon Medicaid) which serves 34% (1.47 million) of people in Oregon. The most effective way to improve screening rates for Oregonians in these demographic groups, is to work with Federally Qualified Health Clinics (FQHCs) and other community-based primary care practices (including tribal clinics) to strengthen their CRC screening programs./ Sixty-one percent of FQHC patients are insured by the Oregon Health Plan and all of Oregon’s FQHCs have CRC screening rates lower than 60%. FQHCs and other community-based clinics also serve as medical catchments for those who are uninsured, underinsured, live in rural areas, have fewer resources and less access to medical care. The purpose of this application is to continue to receive funding to support the creation and maintenance of robust CRC screening programs in clinics across Oregon. If funded, the Oregon Colorectal Cancer Control Program will work over a five-year period to provide a robust Technical Assistance program to approximately 15 FQHCs and other community-based primary care health clinics around specific Evidence Based Interventions defined by the CDC. This work will improve CRC screening rates in communities and ultimately lower CRC burden in Oregon.
