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We are recruiting 50 rural primary care practices for a study that seeks to improve the early detection of, and screening for preventable cancers: colorectal, cervical, and lung cancer throughout the rural parts of the State of Michigan.
Colorectal, cervical cancers, and cigarette smoking are major causes of death in the US. Colorectal cancer is the third leading cause of cancer deaths among men and women in Michigan. While deaths from cervical cancer in Michigan have been declining, in 2019, the ACS estimated 360 new cases, despite an effective vaccine against HPV, the primary cause of cervical cancer. Cigarette smoking is responsible for more than 480,000 deaths per year in the United States; this is about one in five deaths annually, or 1,300 deaths every day. In Michigan, tobacco kills more people than AIDS, alcohol, auto accidents, drug overdoses, murders, and suicides combined.
Residents in rural areas experience a higher incidence of these cancers than urban residents, higher rates of smoking, as well as lower HPV vaccination rates. Both colorectal and cervical cancers have effective screening approaches (colonoscopy, the gold standard for colorectal cancer), and clinician-directed speculum exam (the gold standard for cervical cancer). Many tobacco cessation approaches are effective in the primary care setting. Low-dose computed tomography screening is recommended for high risk older patients due to its effectiveness.
The initial diagnosis is most likely to take place in the primary care setting. So, rural primary care practices could make an important contribution to increasing the health of the patients in their practices. Rural practices could also enhance the workflow in their offices to improve cancer prevention.
Rural primary practices can help by participating in the Primary Care Rural Screening Project through a brief CMO/CEO interview, and a short provider/staff survey to better understand how to improve practices in rural communities. We will send surveys and separately conduct focus groups with a small sample of clinic patients to better understand their own screening practices. All of these contacts are remote; patient participants will receive a monetary incentive.
The benefits to the participating practices will include:
- Increased patient screening resources for reducing colorectal and cervical cancer
- Access to m-health apps to encourage patients to screen for colorectal cancer
- Access to tobacco control programs and lung cancer screening for eligible smokers and former smokers
- Access to home screening approaches for cervical cancer
- Opportunities to enhance office workflow and decrease staff burden for preventive screening
- A small honorarium to participating patients.
- CME to participating providers
- A certificate for completion of the study
- Opportunities to improve Healthcare Effectiveness Data and Information Set* (HEDIS®) and Uniform Data System (UDS) quality measures for cancer screening and tobacco counseling (see: https://www.ncqa.org/wp-content/uploads/2019/07/2020-List-of-Required-Performance-Measures_Final_07.19.19.pdf OR https://www.nashp.org/measurement-and-reporting/)
If your practice is interested in PCRSP participation, please contact Mary Rapai, Project Coordinator, mrapai@med.umich.edu , 734-998-2465.
The study leaders are: Sherri Sheinfeld Gorin, PhD, FSBM, ssgorin@umich.edu, and Masahito Jimbo, M.D., mjimbo@med.umich.edu, Department of Family Medicine, The University of Michigan School of Medicine. We lead a team of internationally-recognized researchers and clinicians in cancer screening and prevention, based at the University of Michigan.
We are funded by the Michigan Institute for Clinical and Health Research (MICHR), The University of Michigan.
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