title: Development of a federally funded demonstration colorectal cancer screening program.
abstract: Colorectal cancer is the second leading cause of cancer-related mortality among U.S. adults. In 2004, treatment costs for colorectal cancer were $8.4 billion. There is substantial evidence that colorectal cancer incidence and mortality are reduced with regular screening. The natural history of this disease is also well described: most colorectal cancers develop slowly from preexisting polyps. This slow development provides an opportunity to intervene with screening tests, which can either prevent colorectal cancer through the removal of polyps or detect it at an early stage. However, much less is known about how best to implement an effective colorectal cancer screening program. Screening rates are low, and uninsured persons, low-income persons, and persons who have not visited a physician within a year are least likely to be screened. Although the Centers for Disease Control and Prevention (CDC) has 15 years of experience supporting the National Breast and Cervical Cancer Early Detection Program for the underserved population, a similar national program for colorectal cancer is not in place. To explore the feasibility of implementing a national program for the underserved U.S. population and to learn which settings and which program models are most viable and cost-effective, CDC began a 3-year colorectal cancer screening demonstration program in 2005. This article describes briefly this demonstration program and the process CDC used to design it and to select program sites. The multiple-methods evaluation now under way to assess the program's feasibility and describe key outcomes is also detailed. Evaluation results will be used to inform future activities related to organized screening for colorectal cancer.
authors.affiliation: Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, 4770 Buford Hwy, Mailstop K-52, Atlanta, GA 30341-3717, USA. LVS3@cdc.gov
authors.forename: Laura C
authors.initials: LC
authors.lastname: Seeff
authors.forename: Amy
authors.initials: A
authors.lastname: DeGroff
authors.forename: Florence
authors.initials: F
authors.lastname: Tangka
authors.forename: Ena
authors.initials: E
authors.lastname: Wanliss
authors.forename: Anne
authors.initials: A
authors.lastname: Major
authors.forename: Marion
authors.initials: M
authors.lastname: Nadel
authors.forename: A Blythe
authors.initials: AB
authors.lastname: Ryerson
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gelb
authors.forename: Eddie
authors.initials: E
authors.lastname: Reed
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D005380:Financing, Government / Q000458:organization & administration*; D006293:Health Promotion / Q000191:economics / Q000458:organization & administration; D006801:Humans; D008403:Mass Screening / Q000191:economics* / Q000458:organization & administration*; D011314:Preventive Health Services / Q000191:economics* / Q000458:organization & administration*; D011785:Quality Assurance, Health Care; D014481:United States