Colorectal Cancer
Johns Hopkins Plays Leading Role in Community-based, Colon Cancer Prevention Program
SINCE 2001, funds have been available to screen low-income residents of Baltimore City for breast, oral, prostate and cervical cancers. Although deaths from colon cancer can be prevented through screening and although the colon-cancer death rate is significantly higher in Baltimore than in the rest of the nation (http://wonder.cdc.gov/mortICD10J.html, accessed 3/14/06), repeated cuts in the state budget earlier in this decade, precluded funding for colorectal cancer screening. So several years ago, local organizations, hospitals and cancer support groups, all led by a representative from the American Cancer Society, came together to find ways to promote colon cancer screening among city residents.
This group is known currently as the Baltimore City Colorectal Cancer Collaborative, a subcommittee of the Baltimore City Plan that is overseeing the implementation of the city’s CRF program. Along with DHMH, the Baltimore City Colorectal Cancer Collaborative applied for and received a three-year grant in September, 2005, from the U.S. Centers for Disease Control (CDC). This award will make colonoscopy available to 300 underserved Baltimoreans each year.
“Our main concern has been the city’s uninsured and underinsured, for they are the ones who do not have access to colon cancer screening,” says JEAN FORD, M.D director of Community Programs and Research at the Kimmel Cancer Center.
Ford joined forces with ANTHONY KALLOO, M.D., director of gastroenterology and MICHAEL CHOTI, M.D., director of the Colon Cancer Center, to help plan the Colon Cancer Collaborative and lead its Hopkins component. As a member of the Collaborative, Hopkins Hospital will be a screening site, along with Harbor, Sinai, St. Agnes and Union Memorial hospitals.
“Colonoscopy will be the primary screening modality," says Kalloo. “We believe this is the most efficient way to diagnose colon cancer.”
But, says Ford, costs are likely to exceed what has already been provided by the CDC. First, colonoscopy itself is relatively expensive. Second, says Ford, “Out of the 300 colonoscopies a year, two to five cases of cancer will be detected that will require treatment, such as surgery and chemotherapy. Those cases wind up being very costly.”
The group plans to apply for more funding to pay for follow-up case management, diagnosis and treatment, and, Ford says, each hospital will be expected to make some in-kind contribution to supplement the CDC grant.
“The available resources are limited, but the program’s impact will be extensive,” says Choti. “It will raise awareness about colorectal cancer screening, not only among the underserved, but also across all Baltimore communities.”
Johns Hopkins is expected to be a key participant in the collaborative, thanks in part to its experience in the CRF-funded Baltimore City Cancer Plan (BCCP). The BCCP, directed by Ford, has engaged numerous local organizations in carrying out cancer-related public-health initiatives in Baltimore. BCCP community education and screening programs are led by Johns Hopkins and the University of Maryland. The Hopkins component of the BCCP initially focused on prostate cancer and then, with a gift from the Avon Foundation, expanded its programs to include breast-cancer education, screening, diagnosis and treatment.
Working with its community partners, Johns Hopkins has provided no-cost screening to 2,300 men for prostate cancer since 2001 and more than 200 women for breast cancer since 2003. Jin Lee, Community Programs Manager in the Kimmel Cancer Center, is coordinating Hopkins’ education sessions and recruitment efforts. Her team works with and among local churches, community organizations and various community health events fairs.
For the colon cancer project, the Community Programs and Research Group Lee will be able to tap into this same local network. Many of the men and women screened for prostate or breast cancer will fit the eligibility criteria for colon cancer testing: age 50 or older with no access to screening because they are uninsured or underinsured. “We already have a waiting list of those who want to be tested for colorectal cancer,” says Lee.
Hopkins is the only major academic medical center in the consortium. “We’ve been at the table from the beginning,” says Ford, “and we believe that our experience in running a large-scale cancer-screening program and following medically underserved populations in the Baltimore City Cancer Plan is highly relevant to the Collaborative.”
For more information on cancer screenings organized by the Johns Hopkins Community Programs and Research Group, call 410-955-1348.
Downloadable Documents
Conquest Article-Colon Cancer Screening
