Case Study: MedStar Washington Hospital Center

Colorectal Cancer Prevention in the Neighborhood Program (Washington, DC)

The Cigna Foundation partnered with and provided programmatic support for the Washington, D.C.-based Medstar’s Colorectal Cancer Prevention in the Neighborhood (CCPN) Program in 2020. The initiative focuses on good health and well-being, and targets ethnic and racial disparities, and aligns with UN SDGs 3 “Good Health and Well-Being” and 10 “Reduced Inequalities.”

Colorectal cancer is the third-most commonly diagnosed cancer and the second-leading cause of cancer-associated death in the United States.1 Racial minorities and African Americans/Blacks, in particular, are disproportionally affected by colorectal cancer. Washington, DC ranks fifth among all states in incidence of Colorectal Cancer with 45.6 cases per 100,000 people.2 In Washington, DC the incidence of colorectal cancer among African Americans/Blacks is 58 percent higher than among whites. The mortality rate for African Americans/Blacks is also considerably greater (52.1 versus 24.6 per 100,000).3 Although colorectal cancer screening has been found to be life-saving and cost-effective, the current U.S. screening rate is below 50 percent, and almost 30 percent of adults age 50 and over have never been screened for colorectal cancer.4

MedStar Washington Hospital Center’s CCPN Program focuses on reducing structural and economic barriers to colorectal cancer screening in the African American/Black population as well as other underrepresented populations in Washington, DC’s Wards 5, 7, and 8, where the colorectal cancer screening rates are considerably lower than the U.S. average and a high proportion of the population is diagnosed with late-stage colorectal cancer.

In collaboration with the American Cancer Society and the Cigna Foundation, CCPN deploys community navigators to educate community members, complete risk assessments, and distribute fecal occult blood test (FOBT) kits for free LabCorp testing and colonoscopy screenings. CCPN is innovative in utilizing a socioecological model (SEM). Components implemented correspond with one or more of five SEM bands of influence: individual and community education, community navigators, FOBT kit distribution, genetic counseling, colorectal cancer Screening nurse navigators, reminder systems, and the stakeholder committee. In addition to these evidence-based resources for use within local communications, the community navigators use ethnically sensitive navigation as part of colorectal screening and follow-up care after screening.

2020 Impact Metric:

  • 25 new community partnerships made in the Washington, DC, metro area
  • 76 community events held during the grant cycle
  • 1,302 people educated on preventive care measures
  • 128 FOBT kits distributed
    • 69 kits returned
    • 65 negative kits returned (no additional testing is needed as the patient is unlikely to have colon cancer)
    • 4 positive kits returned (additional testing - such as a colonoscopy - is needed to determine if the patient has colon cancer)
  • 54 people were provided with colonoscopy referrals
    • 40 positive colonoscopies (a colonoscopy is considered positive if polyps or abnormal tissue is found in the colon)
    • 14 negative colonoscopies (a colonoscopy is considered negative if no abnormalities are found in the colon)
MedStar Washington Hospital Center conference table with volunteers

1The American Cancer Society medical and editorial content team. “Key Statistics for Colorectal Cancer.” American Cancer Society, 12 Jan. 2021, www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html.

2The American Cancer Society medical and editorial content team. “Colorectal Cancer Rates Higher in African Americans, Rising in Younger People.” American Cancer Society, www.cancer.org/latest-news/colorectal-cancer-rates-higher-in-african-americans-rising-in-younger-people.html.

3DC Health. “What is Cancer?” DC Health - Cancer, District of Columbia Cancer Control Programs, https://dchealth.dc.gov/service/cancer. Accessed 5 May 2021.

4Centers for Disease Control and Prevention Division of Cancer Prevention and Control. Colorectal Cancer Screening Rates. 26 June 2020, www.cdc.gov/cancer/ncccp/screening-rates/index.htm.