1. www.kdheks.gov Our Vision – Healthy Kansans Living in Safe and Sustainable Environments

2. Increased Colorectal Cancer Screening Rates and Lifestyle Improvements Can Reduce Morbidity, Mortality and Save Health Care Dollars Rachel Lindbloom, MA, LSCSW Office of Health Assessment KDHE

3. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Colorectal Cancer Numbers and Costs are Important! In 2007, CRC was the 3 rd leading cause of cancer death for Kansas men and women. In Kansas, 500 annual deaths are attributable to CRC. More than 1,000 Kansas hospital discharges are due to CRC annually.

4. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Things to Consider in Reducing CRC Counts and Costs Non-Modifiable Risk Factors Modifiable Risk Factors Preventive Screening and Follow-up

5. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Non-Modifiable Risk Factors Family History History of Bowel Disease History of Adenomatous Polyps Genetic Traits DiabetesAge

6. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Modifiable Risk Factors Alcohol Consumption Red or Processed Meat Consumption Physical Inactivity Overweight and Obesity Smoking

7. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Preventive Screenings and Administration Rates Fecal Occult Blood Test (FOBT): Recommended bi-annually or annually if 50+ Recommended bi-annually or annually if 50+ In 2006, BRFSS results show an estimated 74.8% of adults age 50+ had not received an FOBT during the preceding 2 years. In 2006, BRFSS results show an estimated 74.8% of adults age 50+ had not received an FOBT during the preceding 2 years. Flexible Sigmoidoscopy: Recommended every 5 years 50+ Recommended every 5 years 50+Colonoscopy: Recommended every 10 years age 50+ Recommended every 10 years age 50+ In 2006, BRFSS results show that 43.5% of adults 50+ had never received a sigmoidoscopy or colonoscopy. In 2006, BRFSS results show that 43.5% of adults 50+ had never received a sigmoidoscopy or colonoscopy.

8. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Reducing CRC Incidences and Hospitalization Costs Minimize risk factors. Have regular periodic screenings at recommended intervals. Remove adenomatous polyps if detected. Increasing CRC screening rates and improving healthy lifestyles could reduce CRC incidences and hospitalization costs by 50%.

9. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Methodology Data Used Private Insurance Cost Estimates: Kansas Health Insurance Information System (KHIIS) data; 2003-2005. Private Insurance Cost Estimates: Kansas Health Insurance Information System (KHIIS) data; 2003-2005. Medicaid Cost Estimates: Kansas Medicaid data; 2005-2006. Medicaid Cost Estimates: Kansas Medicaid data; 2005-2006. Medicare Cost Estimates: Kansas Medicare estimates based on national averages supplied by Ingenix; 2003-2006. Medicare Cost Estimates: Kansas Medicare estimates based on national averages supplied by Ingenix; 2003-2006. Frequencies: ICD-9 Codes (152-154) and associated DRGs (146-150, 152-158, 164-165, 170-173, 468, 476-477, 185, 541, and 567-570); Kansas Hospital Association (KHA) discharge data; 2003-2006. Frequencies: ICD-9 Codes (152-154) and associated DRGs (146-150, 152-158, 164-165, 170-173, 468, 476-477, 185, 541, and 567-570); Kansas Hospital Association (KHA) discharge data; 2003-2006. 2003 Cost Comparison Estimates: Consumer Price Index for Medical Care 2003 Cost Comparison Estimates: Consumer Price Index for Medical Care

10. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Hospital Discharge Frequencies, Charges, and Adjustments; Kansas 2003-2006 Hospital discharges declined somewhat. Actual and adjusted CRC mean charges increased by 18.4% and 4.7%, respectively.

11. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Hospital Discharge Frequencies, Payments, and Adjustments; Kansas 2003-2006 Actual and adjusted CRC mean payments increased by 26.5% and 11.8%, respectively. Improved screening rates could reduce CRC charges and payments by 50%

12. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment What If Increased Screening and Improved Healthy Lifestyles Impacted CRC by 50%? Annual Kansas hospitalization charges could decrease from $23 Million to $11.5 Million. Annual Kansas hospitalization payments could decrease from $15.6 Million to $7.8 Million. CRC hospitalizations could decrease from approximately 1,000 to 500 per year. CRC deaths could decrease from 500 to 250 annually.

13. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Data Limitations Hospital Discharge data Lacks patient identifiers, producing duplicate patient counts. Lacks patient identifiers, producing duplicate patient counts. limited data matching capacity. limited data matching capacity. Estimates are not available for pharmaceuticals, health care professional charges, periodic screening costs, or outpatient office costs. KHIIS data estimates are based on largest insurers only. Specialty Hospital, IHS, ERISA and VA data are not available for analysis.

14. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Conclusions CRC is identified as a major priority because existing knowledge has a great potential to prevent cancer, save lives and diminish suffering. Improved screening rates can reduce CRC incidence rates and health care costs in Kansas. A public informed about risk reduction and treatment strategies is critical to success in reducing CRC and its effects.

15. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Acknowledgements Thanks to KHPA for their part in providing KHA, KHIIS and Kansas Medicaid data for analysis. Thanks to the Office of Health Promotion staff who reviewed materials that were important in generating this presentation.

16. Our Vision – Healthy Kansans Living in Safe and Sustainable Environment Contact Information Rachel Lindbloom Health Data Analysis Section Chief Bureau of Public Health Informatics Kansas Department of Health and Environment Curtis State Office Building 1000 SW Jackson Street, Suite 130 Topeka, Kansas 66612 (W) 785-296-8627 (F) 785-368-7118 rlindblo@kdhe.state.ks.us

17. www.kdheks.gov Our Vision – Healthy Kansas Living in Safe and Sustainable Environments