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Action Plan on Colorectal Cancer for the State of Texas

Contents
Executive Summary
Introduction
 
The Challenge: Colorectal Cancer in Texas
  What is Colorectal Cancer?
Risk Factors
Incidence and Mortality
Prevention and Screening Guidelines
Current Knowledge, Attitudes and Practices
Access to and Availability of Services
Financial and Policy Issues
Current Resources
 
Recommendations
Conclusion
References
Appendices
  A. Texas Counties with Highest Colorectal Cancer Mortality, 1990-97
  B. Texas Medical Association Physician Survey
  C. ACS Division Colorectal Cancer Outcomes, 2000-2005
  D. Windsor Village United Methodist Church LIFE Ministry Strategic Plan
 
 
 

Introduction - Project Charge

In 1999 the Texas Cancer Council allocated funding for the formulation of an Action Plan on Colorectal Cancer for the State of Texas. The goal of the project was to identify the education, prevention and support resources currently available in the state and to recommend and prioritize those needing development, to reduce the impact of colorectal cancer in Texas.

A dynamic committee was assembled that included physicians from private and public healthcare sectors, epidemiologists and behavioral science experts, representatives from the Texas Department of Health and the American Cancer Society, Texas Division, various non-physician healthcare professionals, public affairs and media specialists, survivors and family members and featured geographical representation from El Paso, Dallas, San Antonio, Lubbock, Rio Grande Valley and West Texas. The committee was chaired by Bernard Levin, M.D., Vice President for Cancer Prevention at The University of Texas M. D. Anderson Cancer Center in Houston. Members included:

Frank Ambriz, P.A.-C.,
The University of Texas — Pan American,
Edinburg

Grace Butler, Ph.D., survivor,
The University of Houston,
Houston

Silvia Castañeda, Healthbeat reporter,
KPRC-TV Channel 2,
Houston

Susan Cooley, Ph.D., R.N., survivor,
Houston

Pearlie Fennell, Ph.D.,
Texas Southern University,
Houston

Jeff Hurley, M.D.
Dallas

Nora JanJan, M.D., Radiation Oncology,
U.T. M. D. Anderson Cancer Center,
Houston

Constance Johnson, R.N., Cancer Prevention,
U.T. M. D. Anderson Cancer Center,
Houston

Rosalie Johnson, R.N., C.E.T.N.,
Wound, Ostomy & Continence,
U.T. M. D. Anderson Cancer Center,
Houston

Jordan Lovy, D.O.,
AmCare Health Plans, Houston

Gayle McMorrow, family member,
Houston

Ann Marie Newman,
Associate Vice President – Diversity,
American Cancer Society, Texas Division,
Austin

Kimberly Ridl, M.D.,
The University of Texas Medical Branch
Galveston

Catherine Ronaghan, M.D., F.A.C.S.,
Texas Medical Association,
Lubbock

Alison Ruffin, Public Affairs
U.T. M. D. Anderson Cancer Center,
Houston

Rolando Saenz, M.D.,
San Antonio

Juanita Salinas,
Adult Health Programs,
Texas Department of Health,
Austin

Virginia Schneider, P.A.-C.,
Director, Physician Assistant Program,
Baylor College of Medicine,
Houston

Roxanne Tyroch, M.D.,
Texas Tech University Health Sciences Center
El Paso

Sally W. Vernon, Ph.D.,
The University of Texas School of Public Health,
Houston

Laura Wood,
Harris County Hospital District,
Houston

Ex Officio:

Gerald D. Dodd, M.D.,
Diagnostic Radiology,
U.T. M. D. Anderson Cancer Center,
Houston

Lewis Foxhall, M.D.,
Referral Relations Office,
U.T. M. D. Anderson Cancer Center,
Houston

Sarah Tropman Hawley, Ph.D.,
Baylor College of Medicine,
Houston

Harry Holmes, Ph.D.,
Governmental Affairs,
U.T. M. D. Anderson Cancer Center,
Houston

Mickey L. Jacobs, M.S.H.P.,
Executive Director, Texas Cancer Council,
Austin

Alex Prokhorov, M.D.,
Behavioral Science,
U.T. M. D. Anderson Cancer Center,
Houston

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Plan Development Process and Timeline

The initial planning meeting for the project was held August 24, 1999. The full committee was recruited by mid-October, and a project timeline was constructed to convene three in-depth discussion sessions to address the many facets of colorectal cancer in Texas, including prevention, screening and detection; diagnosis and treatment; and rehabilitation, symptom control and palliative care. Guest presenters contributed their expert perspectives to the meetings. The Steering Committee identified a number of major issues and proposed a range and variety of strategies.

In April and May 2000, the committee was reorganized into a number of smaller “working groups,” to discuss in more depth the recommended goals and strategies from specific points of view. They defined a number of needs more precisely and designated priorities. In its fourth meeting the full committee confirmed its recommendations formatted in alignment with the 1998 Texas Cancer Plan.

The draft Action Plan document was reviewed and revised by members of the Steering Committee and Texas Cancer Council staff. The final printed document is scheduled for distribution to healthcare professionals, educators, policy-makers and opinion leaders, and for public posting on the World Wide Web, by the end of summer. The committee will convene one more time in August 2000 to discuss implementation of its recommendations.

  Schedule of Activities
  November 30, 1999 Meeting #1: Prevention & Early Detection
 

January 18, 2000

Meeting #2: Diagnosis & Treatment
  March 27 Meeting #3: Rehabilitation, Symptom Control & Palliative Care
  April to May Working Group Discussions:
Service Availability: Prevention, Screening & Diagnosis
Professional Education
Patient & Family Education
Public Information
Policy Development & Enactment
Research
 

June 9

Meeting #4: Review of Action Plan Recommendations
  June 15 Final Plan to Texas Cancer Council for review
  July 31 Plan completed
  August 15 Plan distributed in hard copy and via Internet

August 15

Meeting #5: Implementation in FY2001

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Acknowledgments

In addition to the project Steering Committee, appreciation goes to the Texas Cancer Council staff and the following people, all of whom contributed to the successful completion of the Action Plan:

Carolyn G. Bernard, Texas Cancer Data Center

Patricia Diana Brooks, M.S., Texas Cancer Data Center

Eduardo Bruera, M.D., U.T. M. D. Anderson Cancer Center

Nora Burkhalter, U.T. M. D. Anderson Cancer Center

Vonna Caleb-Drayton, Ph.D., Cancer Information Service

Linda Civallero, Cancer Information Service

Charles Cleeland, Ph.D., U.T. M. D. Anderson Cancer Center

Ken Condon, Texas Department of Health

Lynn S. Couey, New York State Department of Health

Rosanne L. Evans, U.T. M. D. Anderson Cancer Center

Greg Fredo, Cancer Information Service

Elizabeth Gammon, C.P.A., U.T. M. D. Anderson Cancer Center

Carol J. Garlinghouse, M.S.N., R.N.C., Michigan Department of Community Health

Gayle Harris, Texas Medical Association

Lyone Hochman, M.D., St. Luke’s Episcopal Hospital

Nancy C. Lee, M.D., National Centers for Disease Control

Andrea Littlefield, Breast and Cervical Cancer Control Program, Texas Department of Health

Susan Loehner, Nurse Oncology Education Program

Susan Madigan, R.N., U.T. M. D. Anderson Cancer Center

Gary Marsh, U.T. M. D. Anderson Cancer Center

Andy Miller, M.H.S.E., C.H.E.S., Physician Oncology Education Program, Texas Medical Association

Mark Moreno, U.T. M. D. Anderson Cancer Center

Beth Notzon, U.T. M. D. Anderson Cancer Center

Billy U. Philips, Jr., Ph.D., M.P.H., F.A.C.E., U.T. Medical Branch

David R. Risser, Ph.D., M.P.H., Cancer Registry, Texas Department of Health

Porter Storey, M.D., The Hospice at the Texas Medical Center

Claire Turney, U.T. M. D. Anderson Cancer Center

Sadai Varghese, U.T. M. D. Anderson Cancer Center

Jo Ann Ward, M.P.H., Cancer Information Service

Jane T. Williams, M.S.N., R.N., C.S., F.N.P., O.C.N., U.T. M. D. Anderson Cancer Center

Martha Crosier Wood, Massachusetts Department of Public Health

Jenny E. Young, M.A., Texas Medical Association

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