AUSTIN, Texas — Though colorectal cancer is the second-leading cause of cancer death in the United States, only 35 percent of Travis County residents with limited access to care receive routine screening. And waits for colonoscopy screenings can be up to six months for people with low incomes or without insurance, leaving many vulnerable to the deadly disease.
The Dell Medical School at The University of Texas at Austin will work to address this issue through a new community-wide project that seeks to increase the number of people who receive colorectal cancer screenings and create ways for patients to get follow-up care.
The project — led by Dr. Michael Pignone, chair of the Department of Internal Medicine — is funded by a $2.3 million, three-year grant from the Cancer Prevention Research Institute of Texas (CPRIT). It will engage providers and patients from the area’s Federally Qualified Health Centers (FQHCs), which provide much of the care to people with low incomes or without insurance who experience the greatest challenges to health and care access.
“We’ve made tremendous advances in colon cancer over the past 20 years, and it’s been a very collaborative and gratifying effort,” Pignone said. “But we have a large population of people who have not benefitted from that yet. This project will allow us to work on a larger solution for those who haven’t had access to that level of care.”
Working first with patients served by CommUnityCare — Central Texas’ largest FQHC network — Pignone’s team plans to mail fecal immunochemical tests to about 13,000 patients who are not up to date with screening. These tests screen for small amounts of blood in the stool, an early sign of colon cancer. Recipients who choose to complete the screening will mail the test back for analysis, free of charge.
When the test is positive, “patient navigators” will follow up with patients to help them get scheduled for and complete follow-up colonoscopies, which can detect and remove pre-cancerous polyps and can help prevent cancer from developing. The CPRIT grant provides funding for the colonoscopies, helping to overcome another barrier to care.
The project is being implemented in coordination with the Community Care Collaborative (CCC), which helps leverage the expertise of Dell Med leaders to create new and better resources to serve Travis County’s low-income and uninsured populations. Created by Central Health — the public health care district serving Travis County — and the Seton Healthcare Family (a member of Ascension), the CCC funds health care services through a broad network of providers.
“We’re excited to see how this project will benefit the low-income and uninsured residents we are dedicated to serving,” said Dr. Mark Hernandez, CCC chief medical officer and a Seton physician. “Preventive care is a cornerstone of our work. Our health care system works better when we treat patients early and avoid unnecessary hospitalizations. We welcome any additional resources we can find to improve cancer screenings and get patients the care they need faster."
The project also will create a comprehensive list of patients who require follow-up colonoscopies after polyp removal. This will allow health care providers to remind those at-risk for colorectal cancer to have regular follow-up care and help work down the backlog of patients waiting for testing.
This emphasis on prevention and patient health demonstrates the multi-disciplinary, patient-centered approach that the Dell Medical School’s Livestrong Cancer Institutes are taking to fighting the disease, said Dr. S. Gail Eckhardt, who directs the Institutes.
“A lot of people on that waiting list have high risk profiles,” Eckhardt said, referring to the roughly six-month wait for Travis County residents with low incomes or without insurance to receive a colonoscopy. “This program is important because it tailors care to people who need it and increases cancer screening resources across the board, helping ensure that everyone in our community has access to early and effective cancer prevention."