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Colorectal Cancer Burden and Access to Federally Qualified Health Centers in California

Brendan Darsie, MPH; Jennifer Rico, MA; Madhurima Gadgil, MPH; Joshua Tootoo, MCP



Colorectal cancer (CRC) is the third most common cancer in California among both men and women and the third most common cause of cancer-related death (1). CRC mortality in California has declined over the past 25 years, due in part to increased screening rates (2). Early detection of CRC greatly increases survival, but more than 50% of people with CRC cases are diagnosed at a late stage (3). Californians diagnosed with CRC that is localized to the colon or rectum have a 95% 5-year survival rate (3). However, when CRC has spread to the lymph nodes, 5-year survival drops to 66%, and when the cancer has spread to distant organs, 5-year survival is only 12%. Thus, screening is essential to the early detection and successful treatment of CRC.

Socioeconomic status is a strong predictor of colorectal cancer screening (4). Studies have shown that people with low income and limited or no health insurance face many barriers to accessing health care services and screening for CRC (4). Increasing screening rates among low-income and underinsured people may significantly decrease the burden of CRC. Federally qualified health centers (FQHCs) are an important source of primary care for low-income and underinsured Americans. FQHCs receive approximately 40% of their funding from federal grants that mandate the provision of health care to an underserved population, the implementation of a sliding fee scale based on income, and the provision of comprehensive health services, including CRC screening (5). This GIS Snapshot examines geographic variation in the percentage of late-stage CRC diagnoses in California and the percentage of the population within a 30-minute drive time to an FQHC.

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Publication date: 
Thursday, October 8, 2015