Addressing Barriers to Colorectal Cancer Screening by Implementing a Colorectal Cancer Screening Program on a Mobile Health Unit

Abstract

INTRODUCTION: Several barriers to healthcare access contribute to disparity in colorectal cancer screening. We developed a program to address structural and financial barriers to colorectal cancer screening in our community using an established mobile health unit. METHODS: This mobile health team aims to improve health and prevent chronic disease by providing wellness education and taking physiological measurements such as glucose and blood pressure. In partnership with this unit, we began providing fecal immunochemical test (FIT) tests to English- and Spanish-speaking patients aged 45 years and older during their visits to the mobile unit for other health examinations. Participants complete the FIT at home and return it via postal mail. A patient navigator follows up with participants. If the FIT is positive, the participant undergoes a colonoscopy. If the participant is uninsured, cost of colonoscopy and/or cancer care are covered by our institution. Participants complete surveys at baseline, test completion, and upon receiving their results. RESULTS: We have enrolled 34 participants, 65% women, median age: 55 years (interquartile range = 12). The majority (90%) of patients did not have health insurance, and 76% were Spanish-speaking. Most (88%) knew they were due for colorectal cancer screening, but 85% had never been screened for various reasons (Table). To date, 71% of participants have completed FIT testing, and 100% of completion survey respondents plan to repeat FIT testing next year. CONCLUSION: Our preliminary results demonstrate the feasibility of addressing structural and financial barriers to colorectal cancer screening by initiating FIT testing programs on existing mobile community health units. Table. - Enrollee-Reported Primary Past Barriers to Colorectal Cancer Screening Barrier Percentage I’ve never had the opportunity 26% I don’t have insurance 19% I didn’t think it was necessary 14% Testing is too expensive 11% I don’t know 11% Other 19%