Colorectal Cancer in Appalachia: Understanding the Burden through Community-based Initiatives

1. Colorectal Cancer in Appalachia: Understanding the Burden through Community-based Initiatives Presented by the Meigs County Cancer Initiative, Inc. Doretta Thomas, CHW Angela Carter Melissa Thomas

2. Coalition Background Meigs County Cancer Initiative

3. The Mission of MCCI The Meigs County Cancer Initiative (MCCI) began as a result of the high incidence and mortality rates of certain cancers in the Appalachia region of the country. MCCI focuses on increasing awareness, providing education, and promoting early detection and prevention of cancer in Meigs County, Ohio.

4. Acknowledgements Diana Coates, Chair Carol Adams, Treasurer Becky Baer Lenora Leifheit Melissa Thomas Steve Ferguson

5. Meigs County Cancer Initiative The Burden of Cancer MEIGS COUNTY CANCER INCIDENCE RATES Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002. Average annual rate per 100,000, age-adjusted to the 2000 US standard population. *=Data did not meet the standard of 90% complete for 1999 for this county.

6. Meigs County Cancer Initiative The Burden of Cancer (cont.) MEIGS COUNTY CANCER INCIDENCE RATES Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002. Average annual rate per 100,000, age-adjusted to the 2000 US standard population. *=Data did not meet the standard of 90% complete for 1999 for this county.

7. All Cancers Lung Cancer Colorectal Cancer # of Cases in 1999 Rate # of Cases in 1999 Rate # of Cases in 1999 Rate State of Ohio 101,099 219.1 29,742 64.0 11,307 24.6 Meigs County 288 274.0 103 97.5 29 27.3 Meigs County Cancer Initiative The Burden of Cancer (cont.) MEIGS COUNTY CANCER MORTALITY RATES Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002. Average annual rate per 100,000, age-adjusted to the 2000 US standard population.

8. All Cancers Female Breast Cancer Prostate Cancer # of Cases in 1999 Rate # of Cases in 1999 Rate # of Cases in 1999 Rate State of Ohio 101,099 219.1 8,067 30.9 5,827 34.8 Meigs County 288 274.0 17 31.0 11 25.3 Meigs County Cancer Initiative The Burden of Cancer (cont.) MEIGS COUNTY CANCER MORTALITY RATES Source: Ohio Cancer Incidence Surveillance System, Ohio Department of Health, 2002. Average annual rate per 100,000, age-adjusted to the 2000 US standard population.

9. About Our Study • Conducted in December 2000 • Survey collection sites: local grocery stores • Powell’s Super Value Store • Kroger • Vaughan’s Grocery • Foodland • Pamida • Collection Period: Two weeks • December 4-15

10. Survey Development • Adapted from a 10-question online survey • Developed by Dr. Signey J. Winawer, from Memorial Sloan-Kettering Cancer Center • Multiple-Choice Format • Included Age, Gender, Address Demographics • Incentive—Drawing for $100 held prior to the holidays

11. Results • 1046 surveys were completed over the two-week period! • After removing duplicates, 1005 surveys remained. • Key findings: • Underesimated frequency of colorectal cancer • Overestimated frequency of colorectal screening tests • Thought sigmoidoscopy and colonoscopy were annual tests • Majority of participants thought colorectal screening tests should begin at age 40

12. Designing the Intervention • Goals • To increase knowledge of colorectal cancer • Risk Factors • Screening Guidelines • To increase compliance of colorectal cancer screening guidelines • To increase awareness of local resources for colorectal cancer screenings • Medicare for individuals over 60 years of age • Local clinics/hospitals who provide colorectal cancer tests

13. Designing the Intervention (cont.) • The method: brochure testing • NCI brochure on colorectal cancer • NCI brochure targeted toward Medicare-age individuals • MCCI-developed brochure that targeted weak knowledge areas • Screening test definitions • Screening guidelines • Risk factors

14. 2000 MCCI Colorectal Cancer Survey 2000 MCCI Colorectal Cancer Survey Participants Age 59 and Under (P1) Participants Age 59 and Under (P1) Participants Age 60 and Over (P2) Participants Age 60 and Over (P2) Control Group 1 (C1) Control Group 1 (C1) Target Group 1 (T1) Target Group 1 (T1) Target Group 2 (T2) Target Group 2 (T2) Control Group 2 (C2) Control Group 2 (C2) Target Group 3 (T3) Target Group 3 (T3) Target Group 4 (T4) Target Group 4 (T4) Designing the Intervention (cont.)

15. The Process • Mailed brochures/letters to all intervention groups on 9/1/03. • Six-month delay until T2 survey is mailed. • Awaiting results of T2 survey • Have reported findings in community meeting forum.

16. Final Thoughts… • Completely community-based • Partnered with local agencies and ACN to maximize resources and reduce cost • Simple research design • Wanted to test the effectiveness of brochures for information dissemination • Developed original brochure that targeted key knowledge areas • Results will be published in public health journals

17. Contact Information Meigs County Cancer Initiative, Inc. PO Box 85 Pomeroy, OH 45769 Phone: 740-992-2161 (Diana Coates) 614-544-5287 (Melissa Thomas) Email: mcci4@yahoo.com