title: Improving access to colorectal cancer screening through medical philanthropy: feasibility of a flexible sigmoidoscopy health fair for uninsured patients.
abstract: OBJECTIVE
  Only half of eligible patients in the United States undergo colorectal cancer (CRC) screening as recommended. Hypothesizing that the medical philanthropy platform may be effective in improving access to CRC screening, we aimed to demonstrate the feasibility of a flexible sigmoidoscopy (FS)-based CRC screening "health fair" for uninsured patients.
  
  
  METHODS
  Uninsured patients older than 50 years who had not undergone CRC screening in the preceding 10 years were recruited through local free clinics and health fairs. A standard medical clinic was transformed into a fully functional endoscopy unit. Medicolegal protection for volunteers was obtained through the Florida Department of Health's Volunteer Health Care Provider Program. Unsedated FS with polypectomy was performed. Those with high-risk endoscopic features were given instructions on obtaining a full colonoscopy.
  
  
  RESULTS
  Fifty-two patients without access to any form of CRC screening underwent FS. Ninety-four percent had an adequate bowel preparation, although 40% required on-site enema. Eighteen patients had a total of 22 polyps, 4 of which were adenomatous. There were no complications. The total cost of the fair, excluding donated resources such as endoscopes and processors, was $6,531.47, amounting to $126 per patient screened.
  
  
  CONCLUSIONS
  Health fair-style CRC screening for uninsured patients is feasible. With improved efficiency, widespread application of CRC screening using the medical philanthropy platform may represent a viable approach to reducing the underuse of CRC screening among the uninsured.
authors: Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, 48109, USA. badihe@umich.edu
authors: B Joseph
authors: BJ
authors: Elmunzer
authors: Mark T
authors: MT
authors: O'Connell
authors: Stefania
authors: S
authors: Prendes
authors: Sameer D
authors: SD
authors: Saini
authors: Daniel A
authors: DA
authors: Sussman
authors: Michael L
authors: ML
authors: Volk
authors: Amar
authors: A
authors: Deshpande
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000517:prevention & control*; D004180:Direct Service Costs / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000191:economics*; D005240:Feasibility Studies; D005260:Female; D005431:Florida; D005653:Fund Raising; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D012812:Sigmoidoscopy / Q000191:economics*; D014481:United States