MAKING A DIFFERENCE — Contributors to the Ohio Valley Health Center’s collaborative colorectal cancer screening program with Franciscan University of Steubenville gathered in the center with a photo of the late Dr. Santiago Ching, another major program contributor. From left are, standing, Dr. Joseph Pathakamuri, Franciscan University biology professor; Ann Quillen, OVHC executive director, and Patrick Kuebler, Franciscan University graduate, and, seated, Dr. Amy Myers-Eisnaugle, Franciscan University nursing department chair; Wilma Ching, wife of Dr. Santiago Ching, and Nyasha DiLeonardo, OVHC nurse practitioner. -- Christopher Dacanay

STEUBENVILLE — In 2023, 153,000 people in the U.S. were estimated to be diagnosed with colon or rectum cancer, with a third of those diagnosed expected to die from it, according to Dr. Amy Myers-Eisnaugle, chair of Franciscan University of Steubenville’s nursing department.

The Ohio Department of Health’s 2023 Jefferson County cancer profile shows that colorectal cancer was the fourth-leading cause of cancer incidence in Jefferson County between 2016 and 2020, and it was the second leading cause of cancer mortality.

Over the years, the rate of colorectal cancer screening has improved, rising from 47.7 percent in 2005 to 71.8 percent in 2021 for those aged 50 to 75, Myers-Eisnaugle said. That’s due in part to additional types of noninvasive screening techniques, which many would prefer over the leading diagnostic method: A colonoscopy.

Health disparities exist despite the increase in screenings — which has yet to meet the American Cancer Society’s 80 percent goal. The highest rates of colorectal cancer in the U.S. are found in American Indians, Alaska natives and African Americans, Myers-Eisnaugle said, and those under the age of 50 are seeing an increasing colorectal cancer incidence rate.

Colorectral cancer is “very treatable” is found early enough, which is why screening is so crucial, Myers-Eisnaugle said, adding, “The best test is the test that gets done.”

To further increase screening rates locally, the university is collaborating with the Ohio Valley Health Center to make noninvasive testing accessible for the community. Supported by donations from a local doctor’s family trust, the OVHC’s colorectal cancer screening program is providing underprivileged populations with early detection efforts that could save lives.

Launched in 2020, the OVHC’s program was the doctoral project of then-nurse practitioner Laura Crimm. Enrolled patients would use a simple take-home test that looks for blood in their stool. If results returned positive, the OVHC would coordinate additional testing and care. Those with a negative test would take it again after one year.

The program received support from Dr. Santiago Ching, a longtime volunteer at the OVHC who contributed his expertise as a gastroenterologist and diagnostician. Ching and his family were also frequent financial contributors to the center, which provides free health care for medically uninsured or underinsured individuals in the Ohio Valley.

Upon Ching’s death at the age of 81 on May 28, 2021, OVHC staff members “weren’t sure how we were going to proceed” with the program, recalled Executive Director Ann Quillen. A “generous donation” from the Ching family ultimately revived the program in 2023, enabling a level of care that wouldn’t be possible otherwise, Quillen said.

The Ching family has reportedly contributed $50,000 to the OVHC since 2020 — not including the $9,000 in memorial donations from others after Ching’s death.

Dr. Ching’s widow, Wilma Ching, said she made the donation to “perpetuate his memory and serve the community.” She acknowledged that her husband would have been pleased with the program’s subsequent growth.

Individuals must be at an average risk for colorectal cancer to be eligible for the OVHC’s program. Those at a high risk will undergo a more direct exam and referral process, generally.

Program eligibility is dependent on various factors, including the patient’s age — 45 through 75 — and personal or family history of cancer. Average-risk patients are those without an immediate family member who’s had or died from colorectal cancer.

Those interested in a colorectal screening should call the OVHC at (740) 283-2856, though walk-ins also accepted at the clinic, 423 South St, Steubenville. Inquirers will be connected with nurse practitioner Nyasha DiLeonardo, who will get eligible patients situated for a same-day test, which is free for uninsured individuals and by donation for the insured.

Franciscan University provides the tests, including iColon Immunochemical Fecal Occult Blood tests, which look for blood in the stool, and optional blood sample tests. The latter is available through a Food and Drug Administration clinical trial for ColoScape, which analyzes the patient’s blood for 61 genetic markers to assess his or her colorectal cancer risk. ColoScape results are not used for diagnosis, though patients can request their results.

If fecal tests return positive, patients will be referred for a diagnostic colonoscopy. Upon uninsured patients’ first visit, the OVHC will begin helping them apply for Medicaid.

If someone doesn’t qualify for Medicaid, the center assists with receiving a reduced-rate colonoscopy. Providing uninsured patients with free medication, including over-the-counter medicine for gastrointestinal issues, is another essential part of the center’s mission.

The OVHC enters colorectal program patients into its system and administers follow-up care throughout the year. The center notifies those patients yearly when it’s time for their next test — something necessary and recommended but not always capitalized on due to fear or a “fatalistic attitude,” Quillen said.

Getting a fecal test through the OVHC means a savings of around $700 per test for patients. That and the tests’ noninvasive nature are ways Franciscan and the OVHC are making screenings more accessible for the community, explained Dr. Joseph Pathakamuri, a professor of biology at the university who coordinates the program with OVHC volunteer Myers-Eisnaugle.

“The colonoscopy is the gold standard for colorectal cancer (testing), but it is also very expensive,” Pathakamuri said. “We wanted to be able to provide something that benefits the local population here, especially the uninsured population. … Compliance is a big issue, so (the program) helps us get the compliance and … the screening that will identify any cancer risk early on.”

Franciscan — which shares a “natural synergy” regarding mission with the OVHC — is committed to serving the local community, Pathakamuri said, noting the university’s screening assistance to Trinity Health System and first responders during the COVID-19 pandemic.

The collaboration has been beneficial for Franciscan students, namely Patrick Kuebler, who completed his pre-med studies and is preparing for medical school.

Involved on the program’s data entry side, Kuebler said of the hands-on experience: “Meeting with some of the patients who are participating in it, it’s been a really fulfilling thing to be a part of, going forward into medical school. When you have your whole career ahead of you, (this) gives you an orientation and points you in the right direction for projects that you can help out more with in the future …”

Also a Franciscan graduate, DiLeonardo has headed local outreach efforts to bring new patients into the program. She’s spoken at churches and other social service providers, as well as called more than a third of the OVHC’s 780 active patients, or those who qualify for a screening.

Thankfully, no OVHC patients have yet been diagnosed with colorectal cancer, but three recent fecal tests have returned positive. All three positives came from African Americans — a fact significant in program officials’ eyes, given aforementioned health disparities.

“We’ve probably had 12 people that have tested positive over the last four years (through a fecal test),” Quillen said, adding later: “We’re trying to break through (screening stigma), making it as easy as possible, making it a one-stop-shop … Everything is all-in-one, and that’s kind of been our goal.”