About the Program
The Michigan Colorectal Cancer Early Detection Pilot Program was designed to pilot a colorectal cancer early detection program for those Michigan residents who do not have health insurance and who are at or below 250 percent of the federal poverty level. The pilot program consisted of two phases — Phase I: Planning (July 1, 2005 – Sept. 30, 2005) and Phase II: Implementation (Oct. 1, 2005 – Sept. 30, 2006).

The expected outcome of this project was a better understanding of how to provide colorectal cancer early detection to Michigan residents who have no health insurance and who meet income requirements. Results of this pilot will guide future expansion of the program to more sites over time and potentially the entire state. In order to have successful expansion of colorectal cancer early detection in Michigan many areas of public health programming will need to explored and evaluated.

Each of the three Michigan counties in which the pilot program is being conducted had a 10-year (1993-2002) colorectal cancer mortality rate that was greater than the colorectal cancer mortality rate for the state as a whole during that same time period.

The three pilot sites used project funding to provide colorectal cancer early detection services following the Michigan Cancer Consortium Consensus Guidelines for the Early Detection of Colorectal Cancer. Sites provided fecal occult blood test (FOBT) screening to asymptomatic residents of average risk and appropriate endoscopic services to persons who were at above-average risk or symptomatic.

Risk Assessment Tools
The MCC Consensus Guidelines for the Early Detection of Colorectal Cancer have integrated relevant risk assessment protocols within appropriate risk-stratified categories. To accompany these recommendations, two draft risk assessment tools were developed in September 2005 and tested through the Michigan Colorectal Cancer Early Detection Pilot Program. Based upon the findings from that testing, the tools were combined in August 2006 into one risk assessment tool.

Self Risk Assessment Tool (September 2005): This form was filled out by the client to help determine program eligibility and the type of colorectal cancer screening test that was appropriate. Depending upon the answers, the client was directed to a screening test (fecal occult blood test for average risk) or further risk assessment by a health professional.

• Self Risk Assessment Form (available as an Adobe Acrobat PDF file)*

Expanded Risk Assessment Tool (September 2005): This form was completed by a health professional asking the client questions.

Questions 1 through 5 were asked by the provider if the client had answered "yes" or "unsure" to questions 1 or 2 or 5 through 9 on the Self Risk Assessment Form.

Questions 6 through 10 on the Expanded Risk Assessment Form were asked by the provider if the client had answered "yes" or "unsure" to questions 3 or 4 on the Self Risk Assessment Form.

If risk factors were confirmed, then the client was screened by colonoscopy and given a referral for genetic counseling, if necessary. If symptoms were confirmed, the client was sent for a diagnostic colonoscopy.

• Expanded Risk Assessment Tool (available as an Adobe Acrobat PDF file)*

Revised Risk Assessment Tool (August 2006): This revised form combines the two September 2005 risk assessment tools into one form that can be used to help determine program eligibility and the type of colorectal cancer screening that is appropriate.

• Revised Risk Assessment Tool (available as an Adobe Acrobat PDF file)*

*Please Note: You will need Adobe Acrobat Reader to open, view and print this file once it has been downloaded. If you need a free copy of Adobe Acrobat Reader, please click here.

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last updated: 01/02/07

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