joni reynolds, rn-cns, msn director of public health programs winnable battles: cancer in colorado
TRANSCRIPT
Joni Reynolds, RN-CNS, MSNDirector of Public Health Programs
Winnable Battles: Cancer in Colorado
Freedom Sculpture by Zenos Frudakis
Challenging
Disparities
CRC 5 Year Cause Specific Survival Rates49% :: High Poverty
Area
57% :: Medium Poverty Area
63% :: Low Poverty AreaSource: Colorado Central Cancer Registry, September 2013% of the population living in poverty :: less than 10% is low, 10% to less than 20% is medium, 20% or greater is high
Breast Cervix CRC0
10
20
30
40
50
60
70
80
Breast, Cervix, CRC % Detected Early by Poverty Level
HighLow
“Early” Detection is percent in situ + localized of staged cases (unknowns excluded)Source: Colorado Central Cancer Registry, CDPHE, September 2013
Opportunities
Freedom Sculpture by Zenos Frudakis
for Change
Already over 900,000 Coloradans access the
roughly 250 community clinics in the state
An estimated 478,000 Coloradans will now be eligible for Medicaid
Baseline Screening Assessment
Infrastructure & Resource Review
EHR Updates
Office Policy & Work Flow Development
Staff Training
Taking the
Leap
Freedom Sculpture by Zenos Frudakis
Cancer and Prevention Guidelines
Ned Calonge, MD, MPH
The ACA and the US Preventive Services Task Force
Lifetime impact of mammography for 1000 women at 40 years of age
Women who will die from breast cancer with no screening
Lifetime impact of mammography for 1000 women at 40 years of age
Women who will not die from breast cancer because of screening
Lifetime impact of mammography for 1000 women at 40 years of age
Lifetime impact of mammography for 1000 women at 40 years of age
Women who will have a false positive mammogram requiring additional procedures
Breast cancer screening in Colorado
• Women age 50 and older with a mammogram in the past 2 years
63%• 2009 incidence of breast cancer
3465• 2012 deaths from breast cancer
585
Cervical cancer screening in Colorado
• Women having a PAP test in the past 3 years79%
• Annual incidence of cervical cancer149
• Annual deaths from cervical cancer 39
Colorectal cancer screening in Colorado
• Adults age 50 and older with visualization (ever) 67%
• 2009 incidence of colon cancer1705
• 2012 deaths from colon cancer 633
Lung cancer in Colorado• Estimated number of smokers
676,000• 2009 incidence of lung cancer
2292• 2012 deaths from lung cancer
1590• Potential lives saved with screening
310• Potential lives saved with no smoking
1431
ACA and USPSTF recommendations
• Should there be a direct link between evidence of net benefit and coverage?
National Cancer InstituteU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESNational Institutes of Health
eHealth for Behavioral Science: LEARNING AT THE SPEED OF TECHNOLOGY
Michael Sanchez, MPH, CHESUniversity of Colorado Cancer Center, October 2, 2013
Aurora, CO
2-10 years
Grant Submitted
Grant Awarded
Develop & Pilot
Test
Recruit & Randomize
Follow-ups Analyze &
Publish
Replications, Reviews & Adoption
Adapted from Bill Riley, NCI
2005 2006 2007 2008 2009 2010 2011 2012
SHOW ME THE
EVIDENCE!
http://www.wired.com/wired/issue/16-07
Fail quickly and often; think MINC
Disseminate across platforms
Implement in rapid learning health systems
Michael Sanchez [email protected]
Patient Navigators Improve Health Outcomes
Elizabeth Whitley, PhD, RNOctober 2013
Denver Health Patient Navigators
Patient Navigation
Elizabeth Whitley, Ph.D., RNPatient Navigator Training Collaborative
www.patientnavigatortraining.org
18 Million Cancer SurvivorsProjected in 2022
Yrs since dx
Cancer Care Continuum
A Coordinated Cancer Care Team
and family caregivers
Ideal survivorship care
Supportive Oncology Care Team
Courage
Heart
Brains