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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/26843520 below:

Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems

Multicenter Study

doi: 10.1158/1055-9965.EPI-15-0470. Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems Michael P Garcia², Andrea N Burnett-Hartman³, Yingye Zheng², Douglas A Corley⁴, Ethan A Halm⁵, Amit G Singal⁵, Carrie N Klabunde⁶, Chyke A Doubeni⁷, Aruna Kamineni⁸, Theodore R Levin⁹, Joanne E Schottinger¹⁰, Beverly B Green⁸, Virginia P Quinn¹⁰, Carolyn M Rutter¹¹; PROSPR consortium

Affiliations

¹ Group Health Research Institute, Seattle, Washington. chubak.j@ghc.org.
² Fred Hutchinson Cancer Research Center, Seattle, Washington.
³ Fred Hutchinson Cancer Research Center, Seattle, Washington. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
⁴ Kaiser Permanente Northern California, Oakland, California.
⁵ Departments of Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
⁶ Office of the Director, NIH, Rockville, Maryland.
⁷ Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
⁸ Group Health Research Institute, Seattle, Washington.
⁹ Kaiser Permanente Medical Center, Walnut Creek, California.
¹⁰ Kaiser Permanente Southern California, Pasadena, California.
¹¹ RAND Corporation, Santa Monica, California.

PMID: 26843520
PMCID: PMC4767632
DOI: 10.1158/1055-9965.EPI-15-0470

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Multicenter Study

Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems

Jessica Chubak et al. Cancer Epidemiol Biomarkers Prev. 2016 Feb.

doi: 10.1158/1055-9965.EPI-15-0470. Authors Jessica Chubak¹, Michael P Garcia², Andrea N Burnett-Hartman³, Yingye Zheng², Douglas A Corley⁴, Ethan A Halm⁵, Amit G Singal⁵, Carrie N Klabunde⁶, Chyke A Doubeni⁷, Aruna Kamineni⁸, Theodore R Levin⁹, Joanne E Schottinger¹⁰, Beverly B Green⁸, Virginia P Quinn¹⁰, Carolyn M Rutter¹¹; PROSPR consortium Affiliations

¹ Group Health Research Institute, Seattle, Washington. chubak.j@ghc.org.
² Fred Hutchinson Cancer Research Center, Seattle, Washington.
³ Fred Hutchinson Cancer Research Center, Seattle, Washington. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
⁴ Kaiser Permanente Northern California, Oakland, California.
⁵ Departments of Internal Medicine and Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
⁶ Office of the Director, NIH, Rockville, Maryland.
⁷ Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
⁸ Group Health Research Institute, Seattle, Washington.
⁹ Kaiser Permanente Medical Center, Walnut Creek, California.
¹⁰ Kaiser Permanente Southern California, Pasadena, California.
¹¹ RAND Corporation, Santa Monica, California.

PMID: 26843520
PMCID: PMC4767632
DOI: 10.1158/1055-9965.EPI-15-0470

Item in Clipboard

Abstract

Background: To reduce colorectal cancer mortality, positive fecal blood tests must be followed by colonoscopy.

Methods: We identified 62,384 individuals ages 50 to 89 years with a positive fecal blood test between January 1, 2011 and December 31, 2012 in four health care systems within the Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We estimated the probability of follow-up colonoscopy and 95% confidence intervals (CI) using the Kaplan-Meier method. Overall differences in cumulative incidence of follow-up across health care systems were assessed with the log-rank test. HRs and 95% CIs were estimated from multivariate Cox proportional hazards models.

Results: Most patients who received a colonoscopy did so within 6 months of their positive fecal blood test, although follow-up rates varied across health care systems (P <0.001). Median days to colonoscopy ranged from 41 (95% CI, 40-41) to 174 (95% CI, 123-343); percent followed-up by 12 months ranged from 58.1% (95% CI, 51.6%-63.7%) to 83.8% (95% CI, 83.4%-84.3%) and differences across health care systems were also observed at 1, 2, 3, and 6 months. Increasing age and comorbidity score were associated with lower follow-up rates.

Conclusion: Individual characteristics and health care system were associated with colonoscopy after positive fecal blood tests. Patterns were consistent across health care systems, but proportions of patients receiving follow-up varied. These findings suggest that there is room to improve follow-up of positive colorectal cancer screening tests.

Impact: Understanding the timing of colonoscopy after positive fecal blood tests and characteristics associated with lack of follow-up may inform future efforts to improve follow-up.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures
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Time to follow-up colonoscopy after…

Figure 1

Time to follow-up colonoscopy after positive fecal occult blood test, by PROSPR healthcare…

Figure 1

Time to follow-up colonoscopy after positive fecal occult blood test, by PROSPR healthcare system, 2011–2012 (GH: Group Health; KPNC: Kaiser Permanente Northern California; KPSC: Kaiser Permanente Southern California; PHHS-UTSW: Parkland Health and Hospital System – University of Texas Southwestern Medical Center; PROSPR: Population-Based Research Optimizing Screening through Personalized Regimens)