Kentucky
Consortium Uses Bi-Level, State and Regional Structure to Advance Colorectal Cancer Control
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Public Health Problem
Colorectal cancer is the second-leading cause of cancer-related deaths in the
United States and the second-leading cause of cancer-related deaths in Kentucky.
The American Cancer Society (ACS) estimates that in 2005, 2,350 new cases will
be diagnosed and 910 deaths will occur from colorectal cancer in Kentucky.
Despite the efficacy of screening in preventing colorectal cancer, compliance
with screening recommendations is very low. According to 2002 survey data from
the Behavioral Risk Factor Surveillance System, only 41.3% of Kentucky
respondents indicated ever having been screened for colorectal cancer using
fecal occult blood testing. The corresponding figure for the United States was
44.8%. Similarly, only 43.9% of Kentucky respondents indicated ever having had a
sigmoidoscopy or colonoscopy test, compared to 48.1% of respondents in the
United States. The ACS Colorectal
Cancer Facts and Figures 2005 reports
that just 39% of all colorectal cancers are diagnosed in their earliest stages,
when the cancers are still localized and survival rates are highest.
Background
In view of these and other data, the Kentucky Cancer Consortium identified
the need to increase screening rates for colorectal cancer as a priority in
Kentucky's Cancer Action Plan.
The consortium includes four workgroups focused on implementing state-level
strategies and 16 regional cancer partnerships focused on implementing
community-level strategies. The regional partnerships were established between
October 2003 and April 2004. The initial meetings of the partnerships involved
495 participants, representing 316 organizations. There was geographic
representation from 115 (96%) of Kentucky's 120 counties.
These meetings included an overview of the Centers for Disease Control and
Prevention's (CDC) plans relating to comprehensive cancer control, an
orientation to the Kentucky Cancer Consortium, a review of local cancer data,
and an assessment of resources and gaps based on the Cancer Action Plan priority
areas. Representatives from local community organizations and groups identified
cancer control activities that addressed the Cancer Action Plan's implementation
goals and objectives at regional and local levels. Participants categorized
these activities along the continuum of care and identified gaps in services. An
analysis of the data revealed limited activities in the state aimed at
increasing awareness among the general public and health professionals of
colorectal cancer and the importance of screening.
In response to this gap, the steering committee worked with the University of
Kentucky Research Prevention Center to develop a request for supplemental
funding from CDC that could help increase colorectal cancer awareness and
screening. In July 2004, CDC approved this funding.
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Program Example
The University of Kentucky Prevention Research
Center worked with the Kentucky Cancer
Consortium's regional cancer partnerships to disseminate mini-grants focused on strategies
to increase colorectal cancer awareness and screening. Workshops attended by representatives of the regional partnerships were held in Lexington, Kentucky, in November 2004, and in Bowling Green, Kentucky, in December 2004. Attendees learned how to plan and implement intervention strategies using evidence-based tools and information.
The Prevention Research Center provided templates and technical assistance relating to proposal development and evaluation. Training on the use of Cancer PLANET and the Guide to Community Preventive Services was also provided
to help the partnerships select implementation
strategies. The partnerships were encouraged
to use CDC's Screen for Life materials and American Cancer Society (ACS) materials in their interventions.
All of the regional partnerships developed collaborative
proposals using the format provided and identified fiscal agents. Awards have been made and implementation of the strategies statewide has recently begun.
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Implication and Impact
The Kentucky Cancer Consortium provided a structure to mobilize communities statewide to address a priority identified in the Cancer Action
Plan. Equally important, the consortium provided a process that encouraged the use of data, facilitated coordination and collaboration, and incorporated evaluation. The consortium also provided support, training, and access to technical assistance. Kentucky's experience demonstrates the importance
of having a cancer action plan to guide statewide and community-level cancer control activities and to focus efforts on addressing gaps. There was unprecedented collaboration by community organizations in developing plans and preparing applications, which strengthened partnerships, extended the reach of activities, and reduced duplication of effort.
Encouraging the use of CDC's Screen for Life materials and ACS materials ensures consistency
in the information being communicated and maximizes the use of existing materials and resources. Communities were also given opportunities to tailor strategies for information dissemination to meet the needs of their geographic
region and population.
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Contact Information
Kentucky Cancer Consortium*
Community Programs Division
University of Kentucky Markey Cancer Control Program
2365 Harrodsburg Road, Suite A-230
Lexington,
KY 40504-3381
(859) 219-0772 Ext. 249
Fax: (859) 219-0548
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