Multi-level Approaches to Improve Home Based Cervical and Colorectal Cancer Screening in Women in Rural Michigan

Why are women 50-65 years old the focus of this study?

  • In the United States, women 50-65 years old are the least likely to screen for cervical and colorectal cancers
  • More than half of the cervical cancers found are detected in women 50-65 years old
  • Colorectal cancers found between 50-65 years old are the most curable
  • Women 50-65 years old are the most likely group to not have public or private insurance due to their high likelihood of non-traditional employment, despite the ACA
  • Living in rural areas, limited education, menopause, and chronic disease are confounders for non-participation in these cancer screens.
  • Changes in sexual partners occur in about 50% of women 50-65 years old due to death, separation, or divorce
  • All women, 50-65 years old, regardless of sexual partner, are at high risk of cervical and colorectal cancer

This study aims to assess home based sampling,

  • This is survey study, -- We will send surveys to women 50-65 years old across 50 primary care practices about home sampling for cervical cancer and colorectal cancer
  • We will interview (10) medical directors and/or IT leaders for the system (organizational leaders)

What are the criteria for inclusion in the study?

Patients will be eligible to participate:

  1. if they are a patient of one of the eligible PCPs in rural counties in Michigan.
  2. age 50-65 years old
  3. have a cervix
  4. have not had cervical cancer
  5. have not had colorectal cancer
  6. do not have genetic predisposition to colon cancer
  7. are eligible to use Cologuard
  8. do not have a life limiting disease (such as cancer, CHF, ESRD, etc)
  9. speak English; and
  10. consent to participate.

What is the long-term goal of the study?

The long-term goal of this study is to improve the cervical cancer and colorectal cancer screening rates of women 50-65 years old. We aim to understand whether the act of home based cervical cancer screening will increase the use of Cologuard/FIT colon cancer screening among women 50-65 years old. We aim to understand if the office flow of cancer screenings can be simplified and increase uptake by mailing home kits. We will develop an easy to use home based screening test whose results will be integrated into the electronic health record for appropriate follow up.