Breaking down barriers to colonoscopy access

Community & consumer engagement Quality improvement

Camden County has one of the lower colorectal cancer screening rates in New Jersey, and our limited data indicate that screening rates are even lower in the city of Camden. Timely access to colorectal cancer screening in the form of colonoscopies is vital: when colorectal cancer is found at an early stage before it has spread, the five-year relative survival rate is about 90 percent. However, only about 4 out of 10 colorectal cancers are found at this early stage, and when cancer has spread outside the colon or rectum, survival rates are lower. About 1 in 3 people in the US who should get tested for colorectal cancer have never been screened. 

Through our work, we’ve found that stigma and fear associated with the colonoscopy procedure (the latter of which has increased by concern of COVID-19 exposure), language barriers, lack of social support to accompany patients to and from the procedure, as well as a complicated scheduling process prevent many individuals from accessing potentially lifesaving colonoscopies. To increase screening rates, particularly among Black and Hispanic Camden residents, we knew we had to meet individuals where they were, both physically and mentally. 

In March, we held an event at Northgate II, a Fair Share Housing Development building in Camden, called “Trust your gut – Learn about colon health from Dr. Jubril” that gave residents an opportunity to learn about types of colorectal cancer screening and colon health, ask questions, and hear from peers who have gone through a colonoscopy experience. 

“Our social services staff supports a majority Latino and African-American resident population who are at high risk of colon cancer,” says Marilyn Mock, Policy Director for Senior and Wellness Services at Fair Share Support Services, Inc. “Underscoring the importance of colon cancer screening can help to save the lives of our residents and their family members. Having Dr. Jubril present to our residents about colon cancer screening helped to de-mystify the colon cancer screening procedure, correct misinformation and misperceptions about colon cancer and the screening procedure, and allay many of the fears and concerns among our resident population.” 

The “Trust your gut” colorectal cancer screening awareness event was part of an ongoing partnership between the Camden Coalition, Northgate II, and ScreenNJ to provide nurse/community health worker-led wrap-around colonoscopy support for Northgate II residents and individuals across Camden County. Patients who are eligible for screening from Northgate II are referred to their in-house community health workers, while other health systems and clinics across Camden County can refer patients to a Camden Coalition nurse. Our nurse and community health worker teams then help patients with:  

  • scheduling appointments,  
  • education on what to expect from the procedure,  
  • support for prepping for the test,  
  • transportation to and from appointments, and  
  • support with language barriers.  

In some cases, we also provide funding to assist with the cost of the procedure or medication. 

The Northgate II event included presentations in English and Spanish on colon health and the colonoscopy procedure from our Medical Director Dr. Jubril Oyeyemi as well as a nutritionist and navigation team from ScreenNJ and the Rutgers Cancer Institute of New Jersey. Camden Coalition Community Advisory Committee member Miguel Rodriguez and a few Northgate II residents shared their colonoscopy experiences, and Nancy Reyes, Community Health Worker at Northgate II, and Sandi Drake, RN, Nurse Care Coordinator at the Camden Coalition, outlined the navigation services available to residents. 

“There exists fear and stigma about colonoscopies, especially in the Black and Hispanic community,” says Miguel. “It was important to bring awareness of what brings about colon cancer and why people should get a colonoscopy.” 

Northgate II resident Frank Ivey shared his positive colonoscopy experience. “A message I would like to share with my fellow residents and friends is to seriously consider and partake in this procedure when you are scheduled to have it done,” he said. “It is important to have this procedure done to make sure that everything is ok.” 

And according to Dr. Jubril, the residents were keenly engaged in learning about gut health and cancer prevention. “As they say, prevention is better than cure,” he notes. “This event elevated the importance of prevention, which in turn engenders trust. We heard from residents at the end of the event that they felt empowered to get their overdue screenings done.” 

Adds Mock, “I think that the most successful part of the event was that residents had the opportunity talk with and ask questions of a knowledgeable and engaging physician of color who understands the importance of colonoscopy screening for minority populations. Dr. Jubril’s representation meant the world to our residents. He has a unique ability to connect with our population and communicate with them in a way that is relatable and without medical jargon.” 

We are continuing to work with Northgate II to provide navigation and support for scheduling and attending colonoscopies. Rutgers Cancer Institute of New Jersey launched a similar navigation program earlier this year. As we build and strengthen an interconnected ecosystem of care in Camden, we will continue to work with our partners to promote health, screening, and chronic disease management education and support so that timely care and services are accessible to all.