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Massey researcher aims to increase colorectal cancer screening in vulnerable communities

Dec 02, 2021

Michael Preston, Ph.D., M.P.H. Michael Preston, Ph.D., M.P.H.

Growing up in rural southeast Arkansas, Michael Preston, Ph.D., M.P.H., saw the value of early screening for colorectal cancer firsthand.

His grandfather was screened early, and doctors were able to stop the cancer before it progressed. Preston credits the screening for getting to enjoy many more years with his grandfather than he would have otherwise.

But Preston, an assistant professor in the VCU School of Medicine and assistant director of health equity and disparities research at VCU Massey Cancer Center, knows that his grandfather was an outlier in rural communities like his, where screening rates for those who qualify are often less than 50%. As a result, his home region of Arkansas is a colorectal cancer hotspot, where mortality is higher than the national average.

“I saw that as something that I wanted to address, and opportunity came along,” Preston said

That opportunity was in Virginia, a state with 22 colorectal cancer hotspot counties of its own, where Preston took a faculty role at VCU in 2019. Now he’ll have the protected research time and funds to support his research through a new program, as the inaugural Wright Faculty Scholar in Health Disparities at the Wright Center for Clinical and Translational Research. The two-year award will support his career with an individualized development plan and the guidance of mentors.

Preston will continue his work on programs that address colorectal cancer screening rates in communities where rates are low.

One program seeks to increase screenings through the use of community navigators, who partner with patients to identify barriers. Navigators follow up with patients who’ve been recommended for a screening but haven’t completed it yet. They ensure patients are aware of the options for screening – be it at home or in the clinic. And they work through the barriers, like transportation to a doctor’s office or instructions in the take-home stool test.

“Navigators try to focus on the needs of the patient, their potential fears and knowledge of navigating the health care system, which can be very complex for most,” Preston said. “With men, there can be a ‘masculinity issue’ when it comes to colon cancer screening, and making them more comfortable about why it’s important to do this is the goal of the navigator.”

Preston’s primary research focus will be to evaluate the efficacy of these programs. His background in implementation science will help him assess the interventions in Virginia communities, especially in rural communities where health care often comes through federally qualified health care centers — community-based clinics that provide primary care services in underserved areas.

“Community health centers actually care for a lot of individuals in Virginia who are uninsured or under-insured,” Preston said. “A large number of individuals who haven’t been screened are in areas that are hard to reach, and the federally qualified health care centers are a great tool.”

But screening rates at Virginia’s 30 federally qualified health care sites vary from 14% to 63%, and Preston hopes the research helps uncover the reasons for this variation. He’s keen to translate what he learns over the next few years into policy.

“Part of this project will be documenting and disseminating our findings to policymakers in a way that influences colorectal cancer mortality in Virginia,” he said. “Colorectal cancer is one cancer that you can actually prevent if people get screened. If we increase screening, we lower the number of people who die from colorectal cancer.”

As a Wright Faculty Scholar in Health Disparities, Preston will have 75% of his time committed to research and receive a supplement of $25,000 per year for research support. Vanessa Sheppard, Ph.D., professor in the VCU School of Medicine Department of Health Behavior and Policy and Massey Cancer Center associate director of community outreach engagement and health disparities, will serve as Preston’s mentor through the scholarship.

“The pandemic only served to exacerbate previously unacceptable low rates of cancer screening in underserved areas. Dr. Preston’s research will be instrumental in helping raise those rates in Virginia for colorectal cancer with an ultimate goal of improving outcomes,” said Massey Cancer Prevention and Control member Patrick Nana-Sinkam, M.D., Wright Center associate director and lead for the new scholar program. “The Wright Center is pleased to partner with him as our first scholar in health disparities and looks forward to supporting his research career.”

Written By: Jackie Kruszewski

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