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The Colorectal Cancer Screening Program at MGH Chelsea works to decrease disparities in colorectal cancer screening rates between Latino and white patients, and to increase screening rates among low-income patients and patients with limited English proficiency.
The Colon Cancer Care Coordinators provide education in Spanish, English, and Serbo-Croatian on colorectal cancer (CRC) screening options and explore a patient’s barriers to CRC screening. They offer “navigation” to help overcome barriers, including scheduling and reminding patients about appointments, helping patients access insurance, explaining instructions for their gastrointestinal preparation, translating written material, and providing emotional support. The coordinators also accompany patients to their gastrointestinal appointments and provide medical interpretation if needed.
To evaluate efficacy of the program, a randomized controlled trial was carried out from January to October of 2007. Patients 52 to 79 years old at MGH Chelsea who were overdue for CRC screening were randomized to an intervention group and assigned a navigator, and a control group that received usual care. Over the nine-month period, intervention patients were more likely to undergo CRC screening than control patients (27% vs. 12%). The majority of the difference among intervention and control patients was attributable to significantly higher colonoscopy rates (21% vs. 10%), one form of screening.
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