Need: Colorectal cancer (CRC) effects the colon and rectum by developing precancerous polyps into cancerous polyps over time (21). CRC is the fourth most diagnosed and the fourth most fatal cancer in the state of Texas (20). Along, with many other types of cancer, CRC is also preventable. This expansion will allow our CPRIT screening project to reach 38 counties in the East Texas region. With the addition of these six counties to our existing 32 county service area, we plan to continue the decrease of the startling incidence and mortality rates of CRC rates. With the utilization of fecal immunochemical testing (FIT) and colonoscopies, CRC can be detected early, if not prevented altogether. E...

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Need: Colorectal cancer (CRC) effects the colon and rectum by developing precancerous polyps into cancerous polyps over time (21). CRC is the fourth most diagnosed and the fourth most fatal cancer in the state of Texas (20). Along, with many other types of cancer, CRC is also preventable. This expansion will allow our CPRIT screening project to reach 38 counties in the East Texas region. With the addition of these six counties to our existing 32 county service area, we plan to continue the decrease of the startling incidence and mortality rates of CRC rates. With the utilization of fecal immunochemical testing (FIT) and colonoscopies, CRC can be detected early, if not prevented altogether. East Texas is primarily a rural and medically underserved community. By expanding to an additional six counties, with a total population of 150,000, we will be able to educate and provide screenings for qualifying individuals (14). By providing these screenings to the un- or under- insured populations of rural East Texas, we will continue to decrease the incidence rates of CRC in Texas. Overall Project Strategy: By expanding geographically to the southern part of our region, we are going to provide services an area that has some of the highest CRC incidence and mortality rates in Texas. This expansion proposal intends to reach the following additional counties: Houston, Jasper, Newton, Polk, Trinity, and Tyler. We plan to increase CRC screening (FIT and colonoscopies) rates by partnering with our existing health centers and adding the following four: Jasper-Newton County Public Health Department, Health Center of Southeast Texas, Health Point Trinity, and Gulf Coast Health Center. We also plan on implementing a professional continuing education component in order to optimize all efforts. This will require the staff to complete an educational series that has an assessment of terminology and processes at the completion of the training. This proposal will represent our plan to expand our screening efforts geographically and provide professional and educational training for staff. Specific Goals: This expansion has two goals: 1) to increase CRC screening education in a 38-county mostly rural area of East Texas, and 2) to increase the rate of CRC screening in the same area. We will increase our goals to a minimum of 5,000 patients screened, 7,500 patients educated, and 1,000 professionals educated. Significance and Impact: Our previously funded CRC screening projects have proven that we can exceed goals and successfully meet metrics even when barriers arise. We will continue to expand and provide screening tools to the medically underserved areas. Being in a rural area poses many challenges such as long distances to the closest medical facilities and difficulty reaching people in such a wide geographical distribution. By partnering with Federally Qualified Health Centers (FQHCs), as well as local health departments, we can utilize both approaches to optimize our preventive goals. By following our improved access to care model, we will continue to build strong partnerships with collaborators, engaging numerous community health facilities to raise awareness for CRC screenings and provide CRC screenings for the un-/under- insured. This funding will assist us in the continuation of educating and screening the public for CRC by putting the primary focus on prevention.

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