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By 2015, levitra generic of Coloradans ages 50 and older will be in compliance with ACS colorectal cancer screening guidelines.
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- Facilitate/encourage public awareness at the local level, across all populations, about colorectal cancer:
1. Include messages both for average risk persons and for persons at higher risk due to their family history of colorectal cancer or adenomas.
2. Engage advocates, such as survivors, caregivers, and navigators in development and distribution of CRC screening messaging.
3. Develop and use messaging that is consistent with other organizations in Colorado, as well as nationally, including ACS/CCGC/USPSTF guidelines.
4. Determine outreach to populations who are pre-screening age to begin to raise awareness.
5. Include messaging to ensure public awareness about new Colorado legislation mandating colorectal cancer screening.
6. Encourage the use of evidence-based strategies for community mobilization.
7. Hold regular meetings with key stakeholders to update progress and introduce newer strategies.
8. Coordinate lifestyle messaging with other organizations, such as levitra generic and levitra generic, with similar goals.
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- Continue the statewide educational campaign to increase knowledge of Colorado health care providers about colorectal screening options, levitra generic
1. Collection of comprehensive family history.
2. Communicate ACS/CCGC/USPSTF screening guidelines, emphasizing commonalities of recommendations.
- Encourage practice changes that facilitate increased screening through measures such as:
1. Patient education about the importance of screening and the screening process.
2. Patient navigation – scheduling, education, coordinate services, assistance with barriers to screening, follow-up.
3. In-reach to eligible patient populations.
- Support the development and use of easy-to-use tools to assist physicians reaching high-risk populations.
- Support the incorporation of quality standards for endoscopic screening into electronic endoscopy reports.
- Educate the primary care provider community to recognize and expect to be provided with data documenting high-quality endoscopic screening.
- Assist the endoscopic provider community to ensure that the data to assess the quality of endoscopic services is available to endoscopists and their referral network.
- Facilitate provider-generated strategies to increase screenings and preventative care
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- Support development of “in-office pathways” that reduce delays in diagnosis of colorectal cancer (iron deficiency, positive stool test, etc.)
- Collaborate with employers and health insurers, such as the Colorado Business Group on Health and Association of Health Plans, to increase screening rates among their insured, particularly the underinsured.
1. Reduce or eliminate co-pays for CRC screening.
2. Collaborate with employers to improve benefit selection and reduce and /or eliminate cost barriers for CRC screening.
- Sustain funding for a program to provide colorectal screening for uninsured and underinsured Coloradans.
- Encourage the next revision of CCGC guidelines to address quality of endoscopic screens.
- Assure adequate capacity in Colorado for colorectal screening services:
1. Encourage lower fees for self-pay patients.
2. Increase CRC screening capacity in rural Colorado and ensure high quality screenings.
3. Promote preventative colorectal screening in the primary care environment, via a medical home.
- Encourage the development of cost-effective strategies for CRC screening.
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- Ensure screening for uninsured and undocumented Coloradans.
- Engage survivors and family members to become advocates for education and screening.
- Develop messaging addressed to legislators, funders, insurers, employers, etc. to create the business case for CRC screening.
- Support development of policy and legislation to secure payment coverage for diagnostic and treatment services for low-income, uninsured Coloradans diagnosed with colorectal cancer.
Support development of policy and legislation to pay for patient navigation and community health workers in the primary care setting.
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- Colorectal cancer, especially under age 60
- Endometrial cancer, especially under age 60
- Ovarian cancer at any age
- Multiple colon polyps (10 or more on a single screening)
- Hereditary Non-Polyposis Colorectal Cancer (HNPCC, aka Lynch syndrome); Familial Adenomatous Polyposis (FAP); or MYH-Associated Polyposis (MAP)
- Inherited mutations to MLH1, MSH2, MSH6, PMS2, APC, or MYH genes
Two to four percent of all colorectal cancer diagnoses are due to an inherited predisposition to colorectal and endometrial cancers. Important screening tools for Lynch syndrome include:
- Family history as outlined above
- Screening colon tumor tissue with MSI, IHC, and/or BRAF lab testing. Tissue screening is more sensitive and specific than family history in detecting Lynch syndrome. Tissue lab screening can be coordinated through most pathology labs. (Genetics In Medicine • Volume 11, Number 1, January 2009, pp 35-41.)