Claxton-Hepburn Medical Center’s Richard E. Winter Cancer Center’s Annual Report to the Community

Claxton-Hepburn Medical Center’s Cancer Committee, comprised of staff from the Medical Center and its Richard E. Winter Cancer Treatment Center issue an annual report, “Public Reporting of Outcomes,” to the community of specific prevention programs they offer and promote. Due to generous grant funding from the St. Lawrence Cancer Fund, and the generosity of St. Lawrence Surgery, Dr. Jeffrey Doyle, and Dr. Myriam Beniamin, Claxton-Hepburn has been able to provide free colonoscopies to uninsured individuals since 2013. This report details the outcomes of the program over the last six years.

From the period of 2013 to 2018, Claxton-Hepburn provided 72 free colonoscopies. Thirty-nine patients were males, and 33 were females. The patients came from 28 different zip codes across the North Country. Fifty-two patients were referred by a primary care provider, 13 patients were referred from program advertising, and seven were referred by word of mouth. We work with many local human services agencies, free clinics, and the New York State Cancer Services program to seek out and screen these individuals. All patients in the program are now tracked and notified when they are due for a repeat screening colonoscopy.

Of the 72 patients, 21 patients had a normal colonic study, and 37 patients were recommended to have a follow-up screening colonoscopy in one to five years. Thirty-two patients had polyps removed, and ten of those polyps were tubular adenomas. According to Webmd.com, tubular adenomas are small clumps of cells that form on your colon lining and are usually harmless. But some of them can lead to colon cancer. Tubular adenomas are the most common types of colon polyps doctors remove. However, they can become cancerous, and that danger goes up the bigger the polyps get.

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In a 2018 Regional Community Health Needs Assessment conducted by the Fort Drum Regional Planning Organization, 71.3% of St. Lawrence County residents surveyed who are age 50-75 reported of having a colonoscopy or colorectal cancer screening in the last ten years. In 2013 the same question was asked, and only 49.2% of residents surveyed age 50, and older reported ever having a screening colonoscopy or colorectal cancer screening. It is evident that our efforts have attributed to an increase in colorectal screening rates. From 2013 to 2018 colorectal cancer rates in St. Lawrence County have increased by 22.1%.

Through education and community outreach efforts, our focus for screening and prevention of colorectal cancer is to align our colorectal cancer screening rates with the “80% by 2018” initiative spearheaded by the National Colorectal Cancer Roundtable. The initiative includes dozens of organizations, including the American Cancer Society, who have committed to eliminating colorectal cancer as a significant public health problem and are working towards the shared goal of reaching 80% of adults aged 50 and older screened for colorectal cancer by 2018. Although the National campaign and St. Lawrence County may not achieve the 80% goal by 2018, the bar has drastically moved towards that goal.

What attributes to high incidences of colorectal cancer in St. Lawrence County? According to the 2017 County Health Rankings, 14% of county residents report poor or fair health. 28% of adult residents are obese, and nearly 30% of all children are obese. 24% of adults report being physically inactive. 54% of adults drink alcohol at least 1-2 times a month or more, and 27% say they consume four or more alcoholic beverages when they drink alcohol. 18% of St. Lawrence County adults smoke, an increase from 14% in 2016. The literature cites that about one-third of cancers can be attributed to tobacco use, while another one-third can be attributed to poor nutrition, physical inactivity, and obesity.

To help combat our obesity epidemic, Claxton-Hepburn provides ongoing free, evidence-based health and wellness programs including the Stanford University’s Diabetes Self- Management Education and its Chronic Disease Self- Management Program, as well as the CDC’s Diabetes Prevention Program, and a Healthy Lifestyle Support Group. Through these programs, participants are taught strategies to eat a healthy diet, be more active, and to take better care of themselves. Participants surveyed post programs generally indicate that they have learned healthier ways to live and have made lifestyle changes based on the programs’ recommendations. One group of fifteen participants from the classes this year collectively lost over 300 pounds through the program. The courses will be offered again in 2019.