West Virginia Clinic Raises Its Colorectal Cancer Screening Rate

Overview

Wheeling Health Right is a free clinic for people without adequate health insurance in the northern panhandle of West Virginia. More than half of its patients are of the recommended age to be screened for colorectal cancer.

One way to prevent colorectal cancer is screening. Almost all colorectal cancer begins as abnormal growths, called polyps, in the colon. Removing these growths can prevent cancer. Wheeling Health Right provided this screening, but only 9% of the eligible patients got screened. The clinic focused on figuring out why.

Listening to patients

With the help of the CDC-funded West Virginia Program to Increase Colorectal Cancer Screening, the clinic began following up with patients and updating medical records. The staff were trained on colorectal cancer screening recommendations, reviewed all patient charts, and updated the data in the electronic health record system.

One reason for the low number of patients screened became clear. The clinic's primary screening method was the fecal occult blood test (FOBT), which patients strongly disliked. Patients can't eat certain foods or take certain vitamins and medicines for a time before they get an FOBT.

The clinic listened. They began using the fecal immunochemical test (FIT) instead, which doesn't have drug or food restrictions. Patients collect a stool sample at home and return it to their doctor. If patients forgot to complete the test, clinic staff called to remind them. These call reminders resulted in a nearly 40% increase in the FIT return rate.

Making changes with the screening test offered, reviewing and updating patient charts, and reaching out with patient reminders had a big payoff. These changes raised the clinic's screening rate from 9% to 53% in 2017, and then to more than 67% in 2018.

Despite this success, there's still work to be done. About one-third of patients still need to be screened for colorectal cancer. The clinic plans to keep listening, learning, and changing to meet the needs of its patients, doctors, and community so it can raise its screening rate even higher.