Colorectal cancer is the second leading cause of cancer-related mortality in the US, with over 52,000 deaths annually. Early detection through screening saves lives, but maintaining these programs is challenging, especially when funding is uncertain. In California, a program called the California Colon Cancer Control Program (or C4P) helped to increase the uptake of fecal immunochemical test (or FIT) screening for colorectal cancer to prevent colorectal cancer deaths and reduce health disparities. The C4P intervention was funded by the Centers for Disease Control and Prevention. Read More
A recent study led by Dr. Ndukaku Omelu from the California Department of Public Health examined whether health systems can sustain colorectal cancer screening efforts without continued financial support from the C4P.
The study focused on seven health systems and their 38 clinics in underserved neighborhoods in California. Dr. Omelu and his colleagues found that many of these clinics have successfully maintained the strategies promoted by the C4P.
For instance, 100% of the clinics have maintained provider reminder systems, which remind healthcare staff that a patient is due for a screening test. All clinics have also sustained their professional development initiatives.
A large majority of clinics – 84% – continue to use patient reminder systems that were implemented to remind patients when they are due for CRC screening. These systems include letters, emails, texts, online app portals, and phone calls alerting patients when they are due for screening. They also include electronic alerts within patient health records that prompt doctors and nurses to recommend screening during visits.
Media campaigns, such as short media messages, posters, and brochures, continue to be used in 71% of clinics. These approaches require minimal ongoing costs and are relatively easy to sustain.
However, more resource-intensive strategies encountered steep declines since funding ended. Only one in four clinics have kept patient navigation services, which help patients schedule appointments and overcome barriers to screening. Even fewer – just one in five – have retained Community Health Workers, who play a crucial role in educating and supporting underserved populations.
Funding stability emerged as the linchpin of sustainability. Programs such as patient navigation and Community Health Workers require staffing, training, and community engagement, all of which depend on reliable funding.
Dr. Omelu and his colleagues emphasize the need for deliberate planning to integrate screening sustainability into routine healthcare best-practices. Automating patient reminders and provider prompts, partnering with health organizations, and securing diverse funding sources can help clinics sustain these life-saving program activities. Optimizing electronic health records can also improve efficiency.
Ultimately, the team’s work shows that fighting colorectal cancer is about more than just screening tests, it’s about building systems that last. Their research offers a blueprint for sustaining colorectal cancer screening programs and many other life-saving public health initiatives.
