Risk of Colorectal Polyps and Malignancies Among Predominantly Rural Hispanics

Background: Soil transmitted helminths (STH) remain a global public health concern in spite of occasional dosing campaigns. Aims: To determine baseline prevalence and intensity of STH infection in east Guatemalan school children, and describe the associated epidemiology of anemia, stunting, and wasting in this population. Setting and design: Ten schools in Izabal province (eastern Guatemala) were identified, and 1,001 school children were selected for this study. Half of the schools were used as clinical testing sites (blood and stool). Materials and Methods: Anthropometric measures were collected from all children. Over 300 children were tested for anemia and 229 for helminth infection. Ova and parasite specimens were examined via Direct, Kato Katz, and McMaster techniques. Hemoglobin was measured from venipuncture following the hemacue system. Statistical analysis: Correlation between infection intensities and growth indicators were examined. Chi Square or t tests were used for bivariate analysis. Multiple logistic regression was performed on significant variables from bivariate techniques. Results: Over two-thirds of school children were positive for infection by any STH. Prevalence of Hookworm was 30%; Ascaris, 52%; and Trichuris, 39%, most as low-intensity infection. Over half of the children were co-infected. In bivariate analysis, anemia was significantly associated with polyparasitism. Conclusions: For a Guatemalan child who experiences a unit decrease in hemoglobin, one expects to see a 24% increase in the odds of being infected with STH, controlling for age, sex, lake proximity, and growth characteristics. Infection with more than one STH, despite low intensity, led to a significant decrease in hemoglobin

Colorectal Cancer Education and Screening Program For The Un- or Under- Insured In A Primarily Rural Setting in Northeast Texas: Design and Methods

Background: Although early detection and screening for colorectal cancer saves lives, screening rates remain suboptimal, especially for minorities, underserved populations, older adults (>60), men, un/under insured, and those living in rural settings. The goal of the colorectal cancer education and screening program is to target the un- or under- insured in a 19-county primarily rural target area to provide: 1) education concerning CRC and CRC screening to 12,000 individuals, and 2) CRC screenings (colonoscopy and/or FIT) to 5,1613 un- or under- insured individuals. Methods: The education outreach team targets local health fairs, clinics, churches, etc. to educate individuals on CRC and the importance of screening. The program aims to then have those individuals electively undergo a colonoscopy and/or a FIT test. The number of those educated and screened is recorded. The results related to colonoscopy, FIT, and follow-up are collected. Results: Primary outcomes include number of individuals educated, number of FIT test/colonoscopies performed and results of screening procedures. Conclusions: This education and screening outreach program is designed to reach primarily rural and underserved populations eligible for colorectal screening. Results of efficacy of program will advance knowledge on how to conduct colorectal cancer outreach programs in rural settings. &nbsp

Colorectal Adenoma Detection Rate in Northeast Texas – Outcome from Community Service Project Using the Fecal Immunochemical Test and Colonoscopy

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States. CRC incidence rates in Northeast Texas, a primarily rural region of the state, far exceed state and national averages. The current study sought to determine the proportion of polyps found in a sample of 5,391 individuals living in Northeast Texas using either colonoscopy or fecal immunochemical testing. In addition, the role of insurance to CRC screening was also investigated. An adenomatous polyp was detected in 44.7% participants in the colonoscopy group and in 2.6% of participants undergoing FIT testing. Additionally, participants in the colonoscopy group who were un- or under-insured were 30% more likely to have an adenomatous polyp detected. While a larger proportion of participants had an adenomatous polyp detected in the colonoscopy group, many including the un- or under-insured are not able to afford, at which point FIT testing may be a better option