Colorectal Cancer

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Joseph Chen
After my 50th birthday, my physician reminded me it was time for my first colonoscopy. I thought I’d always lived a pretty healthy lifestyle. I didn't think it was an urgent matter needed to be done right away. I finally got around to getting it two years later and was stunned when my doctor told me I had early-stage colon cancer. I never expected it could happen to me.
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We can reduce the rates of colorectal cancer by improving early detection and screening.

Colorectal cancer is the second leading cause of cancer death in the United States and a leading cause of years of life lost to cancer in San Francisco.

Screening detects precancerous polyps before cancer can develop, as well as early stage cancers at a time when they can be cured. It is one of the most effective ways to prevent colorectal cancer deaths.

As colorectal cancer screening rates have increased locally and nationally, incidence and mortality from colorectal cancer has started to decline.

UCSF is committed to supporting the 80 by 18 campaign in San Francisco. 80 by 18 means raising the screening rate to 80% of eligible adults by 2018. Many of San Francisco’s health systems are already close to this level of screening, but there is still much to do , particularly among the underinsured and those who belong to medically vulnerable groups served by safety net clinics.

First steps

In our first year, SF-CAN will support safety net clinics belonging to the San Francisco Community Clinic Consortium. This includes technical assistance to increase screening rates, thorough reporting systems, and improving patient navigation to ensure that people with abnormal screening tests receive timely follow up.

UCSF, the American Cancer Society, San Francisco Health Plan, Zuckerberg San Francisco General Hospital, and other community stakeholders are partnering in these efforts.

 

Partners

  • American Cancer Society
  • San Francisco Community Clinic Consortium
  • San Francisco Department of Public Health
  • San Francisco Health Plan
  • UCSF
  • Zuckerberg San Francisco General Hospital and Trauma Center

 


Task Force Recommendations:

By increasing completion of fecal immunochemical tests (FIT) among average risk patients, increasing the screening rate in participating clinics to 80%, and pursuing follow up colonoscopies with at-risk patients, the Task Force hopes to decrease the rate of colorectal cancers in San Francisco within 5 years.


1

STANDARDIZE FIT

Goal: Increased standardization around stool-based testing using single sample FIT

Method: Collaboration with community partners and the San Francisco DPH to all safety net clinics in SF use single sample FIT.

2

SCREENING

Goal: Increase screening of at-risk populations by 10% each year

Method: Help clinics increase CRC screening rates by providing materials, training, and technical assistance. Patient registries established

3

COLONOSCOPY

Goal: Decrease proportion of people without a follow-up colonoscopy within one year of an abnormal FIT by 10% each year

Method: Systematically identify patients with positive FIT and other high-risks and refer to ZSFG for colonoscopies