Kentuckians rank high in colorectal cancer deaths; study will use emergency rooms to promote screening to save lives

University of Kentucky College of Nursing Associate Professor Jennifer Hatcher has received a two-year $359,528 grant for her project, “Promoting Colorectal Cancer Screenings in Rural Emergency Departments.”

The grant, given by the National Cancer Institute, will be used to study how effective motivational interventions are in helping non-emergency patients in rural Appalachian emergency departments to get screened for colorectal cancer, Hatcher said in an interview. Patients' companions in the emergency rooms can also participate in the interviews.

Of cancers that affect both men an women, colorectal cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women, according to the Centers for Disease Control and Prevention.

Kentucky leads the way in these national health statistics.  It has the highest rate of colorectal cancer in the nation at 55.1 per 100,000 and is the fourth highest in the nation for deaths caused by colorectal cancer at 19.8 per 100,000. And those in Kentucky's Appalachian counties have a higher incidence rate than the rest of the state and nation overall at 57.2 percent, according to a Kentucky Colon Cancer Screening Program annual report.

“Residents of rural Appalachia have a higher incidence and mortality rate from colorectal cancer than residents of any other region of the country," Hatcher said in the release. "In light of the fact that colorectal cancer is one of the few cancers that can actually be prevented by screening, this grant presents a tremendous opportunity for us to address one of the key factors affecting this disparity for rural Appalachians—limited access to the health care system."

The interventions for the study will be conducted by lay health workers, trained local people who are interested in the health of the community and helping their neighbors get screened. They will talk to the patients or their companions about their perceived barriers related to colorectal screening and help them work toward resolving those barriers. All interactions are voluntary, Hatcher said in an inteview.

The lay health workers act as connections between the patients and whatever resources they may need to get screened, or helps alleviate fears they may have about colorectal screening. They are also trained to provide education on what types of screenings are available and discuss what is best for each individual.

Patients who agree to the intervention will get a follow-up call one week after the emergency room intervention to see if they need further assistance in setting up a screening and will receive yet another call in three month.

The project will be the first to address the disproportionate incidence and mortality from colorectal cancer in rural Appalachia utilizing the emergency department as an access point, says the release.

"We believe that using an emergency department as an access point for this project will allow us to reach more individuals who are at risk for developing colorectal cancer, thereby reducing the disparate mortality rates that rural Appalachians suffer from this disease,” Hatcher said in the release.