Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 10 - Iowa Get Screened: Colorectal Cancer Program › Rule 641-10.2 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For purposes of this chapter, the following definitions
				apply:
"Advanced registered nurse practitioner"
means
				an individual licensed to practice under 655-Chapter 7.
"Case management"
means establishing,
				brokering and sustaining a system of available clinical and essential support
				services for all individuals enrolled in the program.
"Colon"
means large intestine or large
				bowel.
"Colonoscope"
means a thin, flexible tube that
				takes pictures of the colon and rectum during a colonoscopy.
"Colonoscopist"
means a licensed provider who
				administers a colonoscopy.
"Colonoscopy"
means a visual examination of
				the inner surface of the colon by means of a colonoscope.
"Colorectal cancer," "colon cancer"
or
"CRC"
means cancer that starts in the colon or the
				rectum.
"Colorectal cancer data elements"
or
"CCDE"
means a set of standardized data elements used to
				ensure that consistent and complete information is collected on participants
				whose screening or diagnosis was paid for through the IGS program with state
				funding.
"Department"
means the Iowa department of
				public health.
"Double-contrast barium enema"
means an X-ray
				examination of the entire large intestine (colon) and rectum in which barium
				and air are introduced gradually into the colon by a rectal tube.
"Eligibility criteria"
means a set of
				questions that a potential participant is asked to ensure the participant meets
				program qualifying standards including targeted age, income guidelines, level
				of risk for colorectal cancer and screening determination guidelines.
				Qualifying standards are based on recommendations from the United States
				Preventive Services Task Force (USPSTF).
"Endoscopist"
means a physician who is
				licensed to perform a visual inspection of any cavity of the body by means of
				an endoscope.
"Familial adenomatous polyposis"
or
"FAP"
means an inherited colorectal cancer syndrome and
				accounts for 1 percent of all cases of colorectal cancer. "Familial" means FAP
				runs in families; "adenomatous" means the type of polyps detected in the colon
				and small intestine that may become cancerous; and "polyposis" means the
				condition of having multiple colon polyps. The gene for FAP is on the long arm
				of chromosome 5 and is called the APC gene.
"Family history"
means that a person's close
				relatives (parents, siblings or children) have had colorectal cancer and,
				therefore, the person is somewhat more likely to develop that type of cancer,
				especially if the family member developed the cancer at a young age. If many
				family members have had colorectal cancer, the chances that the person will
				develop colorectal cancer increase even more.
"Fecal immunochemical test"
or
"FIT"
means the primary screening method for the IGS program
				to test for hemoglobin in the feces, a possible sign of colorectal
				cancer.
"Final diagnosis"
means the process of
				identifying or determining the nature and cause of a disease or injury through
				evaluation of patient history, examination and review of laboratory
				data.
"Health care provider"
means any physician,
				advanced registered nurse practitioner, or physician assistant who is licensed
				by the state of Iowa and provides care to IGS-enrolled participants.
"Hereditary nonpolyposis colorectal cancer"
or
"HNPCC"
means an inherited colorectal cancer syndrome and
				accounts for 5 percent of all cases of colorectal cancer. "Hereditary" means
				HNPCC is inherited or can be passed from parent to child; "nonpolyposis"
				contrasts HNPCC to the inherited condition FAP where hundreds to thousands of
				polyps develop in the colon; "colorectal cancer" is the most frequent cancer
				that develops in these families. Patients with HNPCC have an 80 percent chance
				of developing colorectal cancer.
"Informed consent"
means the participant has
				signed the IGS informed consent and release of medical information form and
				therefore voluntarily agrees to participate and receive colorectal services and
				appropriate follow-up through the IGS program. Consent for services can be
				canceled at any time by the participant.
"In-reach"
means the method that will be used
				in the local program to recruit participants. In-reach targets existing clients
				through the Iowa care for yourself program.
"Iowa care for yourself program"
or
"IA CFY program"
means a program that provides breast and
				cervical cancer screening, diagnostics and cardiovascular-related intervention
				services to low-income, underinsured or uninsured women 40 to 64 years of age.
				The IA CFY program integrates program services, as possible, with the IGS
				program. Some IA CFY program participants have been enrolled through in-reach
				activities into the IGS program.
"Iowa get screened: colorectal cancer program"
or
"IGS program"
means the state program which provides
				limited screening services to eligible Iowans and public education and
				awareness.
"Large intestine"
means the last part of the
				digestive tract. The large intestine is divided into sections including the
				ascending which begins at the cecum on the right side, the transverse which is
				the horizontal section, and the descending which is on the left side and
				includes the sigmoid and the rectum. The primary function of the large
				intestine is the absorption of water and the formation and collection of
				feces.
"Local program"
means the entity or facility
				in which IGS services are being offered through a contractual agreement with
				the department.
"Local program coordinator"
means the
				individual within a local program who is providing services to a
				participant.
"Oncologist"
means a specialist physician who
				treats or studies the physical, chemical and biologic properties and features
				of a neoplasm, including causation, pathogenesis and treatment.
"Participant"
means an individual enrolled in
				the IGS program to receive colorectal cancer screening services in accordance
				with the United States Preventive Services Task Force (USPSTF)
				recommendations.
"Pathologist"
means a specialist physician who
				identifies diseases by studying cells and tissues under a microscope.
"Patient navigator"
means the individual who
				identifies and coordinates resources for a participant with a screening
				diagnosis of colorectal cancer who may require physical, emotional, financial
				or other support through the cancer journey. Navigation services are provided
				through a cooperative agreement with the American Cancer Society.
"Physician"
means an individual licensed to
				practice under Iowa Code chapter 148.
"Physician assistant"
means an individual
				licensed to practice under Iowa Code chapter 148C.
"Polyp"
means a growth from a mucous membrane
				commonly found in organs such as the colon and rectum, the uterus and the nose.
				Certain types of polyps, such as adenomas, may develop into cancer.
"Precancerous"
means a condition that may
				become or is likely to become cancer.
"Primary care provider"
means a health care
				provider who provides definitive care to a patient at the point of first
				contact and takes continuing responsibility for providing the patient's
				care.
"Provider agreement"
means a signed
				cooperative agreement between the department and another party, for example, a
				health care provider.
"Rectum"
means the last part of the large
				intestine where stool is stored prior to evacuation through the anus (external
				opening of the digestive system).
"Referral"
means directing program
				participants with abnormal screening results to appropriate resources for
				follow-up action.
"Screening"
means the search for disease, such
				as cancer or precancerous polyps in people without symptoms.
"Secondary complication"
means an additional
				problem that arises following a procedure, treatment or illness.
"Stool DNA (sDNA) test"
means a test that uses
				stool samples to detect abnormal DNA and small amounts of blood shed into the
				stool from colon cancer or colon polyps.
"Surveillance"
means a periodic colonoscopy as
				recommended by a physician on a case-by-case basis for participants with a
				prior history of adenoma(s) or colorectal cancer in accordance with USPSTF
				recommendations. The purpose of surveillance is to rescreen and remove polyps
				that were missed on the initial colonoscopy or that developed in the interval
				since the previous colonoscopy.
"Underinsured"
means an individual with income
				at 300 percent of the federal poverty guideline or lower with health insurance
				that has unreasonably high copayments, deductibles or coinsurance.
"United States Preventive Services Task Force"
or
"USPSTF"
means an independent panel of nonfederal health
				care experts that evaluates the latest scientific evidence on clinical
				preventive services and then sets recommendations for preventive services
				including colorectal cancer screening. These recommendations by USPSTF are the
				guidelines that are followed for recommended colorectal cancer screening by the
				IGS program.