80% In Every Community in Health Centers: Soaring to New Heights

August 5, 2019 – Author: Heather M. Brandt, PhD

August 4-10, 2019 is National Health Center Week (NHCW) and this year’s theme is “America’s Health Centers: Rooted in Communities.” Heath centers serve all people, regardless of who they are, where they are from, and whether or not they have health insurance. For this reason, health centers play a critical role in providing primary and preventive care services to adults who might not otherwise have access to these services, including colorectal cancer screening. Learn more about our nation’s health centers and the care they provide to 28 million patients – or 1 in every 12 people – in every state, territory, and the District of Columbia.

What better week than NHCW to reflect on the incredible progress health centers are making in the fight against colorectal cancer. Colorectal cancer screening rates in health centers have climbed by 12 percentage points (rising from 30.2% in 2012 to 42% in 2017) since health centers began reporting colorectal cancer screening rates through the Uniform Data System (UDS) in 2012. Today you’ll hear from Heather M. Brandt, PhD, about local successes in achieving 80% screening rates in health centers in South Carolina.

Dr. Brandt is professor of health promotion, education, and behavior in the Arnold School of Public Health at the University of South Carolina. She is the program director of the Centers for Disease Control and Prevention-funded Colorectal Cancer Screening Program in South Carolina.

 Additional contributors to this work include Hiluv S. Johnson, LMSW, program coordinator, and Cynthia Calef, MAML, a program implementer, with the Colorectal Cancer Screening Program in South Carolina. We also wish to acknowledge Dr. Crystal Maxwell, Chief Medical Officer of Sandhills Medical Foundation and Kim Hale, Senior Manager of State and Primary Care Systems with the American Cancer Society.

Over the last four years, the Colorectal Cancer Screening Program in South Carolina has worked with eight federally-qualified health center systems and partners in South Carolina to implement evidence-based interventions to increase colorectal cancer screening. When we take a look at the impact of the program within the FQHCs systems in which we work, we have seen an average increase of 17 percentage points in colorectal cancer screening rates from 2015 to 2018. Among the eight health centers that have worked with us the longest, we have seen an average increase of 24 percentage points in this same time frame. While this is a great success, most of our partners fall well below the national 80% goal – but the progress is remarkable and a credit to the hard work and dedication of our health center partners to prevent and detect colorectal cancer early among the clients they serve. How did we land here?

As one of my colleagues (Dr. Karen Kim, University of Chicago) has said, over the past four years of work, supported by the Centers for Disease Control and Prevention’s (CDC’s) Colorectal Cancer Control Program, we have been building a plane while we were flying it. I like to add that we knew we were building a plane, and we knew we wanted the plane to fly and keep flying after the end of the grant. In reviewing our progress, we have built a fine plane that continues to be tweaked as we confront new challenges together. One of the health center systems that has been traveling with us on this journey is Sandhills Medical Foundation, and this health center system has soared to new heights.

Sandhills Medical Foundation has been providing quality comprehensive health care since 1977 as a federally-qualified health center serving rural and largely low-income residents of Chesterfield, Kershaw, Lancaster, and Sumter Counties in South Carolina. Two health center locations – Lugoff and McBee – have been a part of the Colorectal Cancer Screening Program in South Carolina. However, the processes and approaches implemented in these two sites were implemented system-wide. Sandhills Medical Foundation implemented priority, evidence-based interventions of provider reminders and provider assessment and feedback as well as supportive strategies (small media, professional education, training, and technical assistance) and additional activities (signing the 80% Pledge, policy implementation, and developing champions). Facilitation of new system-level changes with a commitment from health center partners, dedicated designated colorectal cancer champions, strong leadership from their system’s Chief Medical Officer (Dr. Crystal Maxwell), implementation of evidence-based interventions, and a standard operating procedure for colorectal cancer screening were all key ingredients. Designated staff members helped to ensure that the process for colorectal cancer screening was being followed. You could consider these important elements of an effective pre-flight checklist.

We highlight successes, leaders, best practices, and tools that are making an impact in the nationwide movement to reach 80% screened for colorectal cancer.

Do you have a suggestion for a future blog topic? We welcome you to share your suggestions by emailing nccrt@cancer.org.


Opinions expressed in these blog posts are that of the author and do not represent policies of the National Colorectal Cancer Roundtable or the author’s institution.

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“We offer colorectal cancer screening at every visit and every type of colorectal cancer screening to our patients. Anything and any way to get them screened!”

Amy Collin, LPN Quality Improvement Director at Sandhills Medical Foundation

Dr. Crystal Maxwell (left), Chief Medical Officer, and Amy Collins (right), CQI Nursing Director, Sandhills Medical Foundation

Based on 2018 data, Sandhills Medical Foundation – as a health center system – is one of two health center systems in South Carolina to have achieved the national goal of 80%. Also based on 2018 data, Lugoff and McBee’s annual colorectal cancer screening rates reached 83%. Dr. Maxwell has attributed the success in exceeding the 80% goal to strong commitment at all levels of the health center system.

Cindy Calef, program implementer with the Colorectal Cancer Screening Program in South Carolina, stated, “We had the pleasure of working directly with two of the four adult primary health care sites of Sandhills Medical Foundation – Lugoff and McBee. I have enjoyed working with the dedicated staff at these sites since 2015. Both of these sites have strong leadership and colorectal cancer champions dedicated to their patients.”

It is safe to say the plane is flying and appears to be on a flight path for future success as evidenced by the achievements of Sandhills Medical Foundation. Fasten your seat belts as we continue to work with our health centers to achieve their goals – and prevent and detect colorectal cancer early through screening.

Lastly, if you work in or with health centers, I strongly encourage you to check out NCCRT’s signature resource for health centers, Steps for Increasing Colorectal Cancer Screening Rates: A Manual for Community Health Centers, as well as other resources in the NCCRT Resource Center, which offer step-by-step instructions on how to implement evidence-based strategies to increase screening in a variety of settings.

We hope you’ll join us in sharing a round of applause for our nation’s health centers. Visit www.healthcenterweek.org to learn more about National Health Center Week and find ways to show your appreciation for their work.

Staff at McBee Clinic