_Colorectal Cancer Screening in Appalachia PA评估在阿巴拉契亚PA结直肠癌筛查课件.ppt

Colorectal Cancer Screening in Appalachia PA: a pilot intervention project William Curry, MD, MS Dept of Family Community Medicine M.S.Hershey Medical Center 7 MAY 2008 Colorectal Cancer Screening in Appalachia PA: a pilot intervention project Mark Dignan, PhD Gene Lengerich, PhD Alan Adelman, MD, MS Brenda Kluhsman, MS Marie Graybill, BSN Colorectal Cancer Second leading cause of cancer deaths 150,000 new cases annually 57,000 annual deaths In Pennsylvania 8,200 new cases annually Rates decreasing except in black males 75/100,000 black males, 49/100,000 white females 3,000 annual deaths 26/100,000 males, 18/100,000 females Pennsylvania Counties Burden of Disease Union County 130 cases per year 20% more cases in males than expected 32 deaths per year 18/100,000 males, 12/100,000 females Northumberland County 190 cases per year 20% more cases in males than expected 163 deaths per year 30/100,000 males, 19/100,000 females Burden of Disease Centre County 271 cases per year 7% fewer cases in males than expected 93 deaths per year 20/100,000 males, 14/100,000 females Snyder 137 cases per year 32% more cases in females than expected 38 deaths per year 19/100,000 males, 17/100,000 females Colorectal Cancer Screening Screening of population is less than optimal 53% in US 49% in PA 44% in Appalachian PA Only 32% of colorectal cancers are found at local stage in rural Appalachia. ACS CRC Screening Guidelines Fecal occult blood test (FOBT)* or fecal immunochemical test (FIT)* every year** *For FOBT or FIT, the take-home multiple sample method should be used. **Colonoscopy should be done if the FOBT or FIT shows blood in the stool ACS CRC Screening Guidelines Flexible sigmoidoscopy every 5 years** **Colonoscopy should be done if sigmoidoscopy results show a polyp ACS CRC Screening Guidelines an FOBT* or FIT* every year plus flexible sigmoidoscopy every 5 years** (Of these first 3 options, the combination of FOBT or FIT every year plus flexible sigmoidoscopy