RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from http://www.ncbi.nlm.nih.gov/pubmed/31146803 below:

Variations in Screening Quality in a Federal Colorectal Cancer Screening Program for the Uninsured

doi: 10.5888/pcd16.180452. Variations in Screening Quality in a Federal Colorectal Cancer Screening Program for the Uninsured

Affiliations

¹ Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop S107-4, Chamblee, GA 30341. Email: mrn1@cdc.gov.
² Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
³ Information Management Services Inc, Calverton, Maryland.

PMID: 31146803
PMCID: PMC6549419
DOI: 10.5888/pcd16.180452

Item in Clipboard

Variations in Screening Quality in a Federal Colorectal Cancer Screening Program for the Uninsured

Marion R Nadel et al. Prev Chronic Dis. 2019.

doi: 10.5888/pcd16.180452. Affiliations

¹ Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop S107-4, Chamblee, GA 30341. Email: mrn1@cdc.gov.
² Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
³ Information Management Services Inc, Calverton, Maryland.

PMID: 31146803
PMCID: PMC6549419
DOI: 10.5888/pcd16.180452

Item in Clipboard

Abstract

Introduction: Screening can decrease colorectal cancer incidence and mortality and is recommended in clinical practice guidelines. Poor quality of colorectal cancer screening can negate the benefit of screening. The objective of this study was to assess the quality of screening services provided by the Centers for Disease Control and Prevention's Colorectal Cancer Control Program from July 2009 through June 2015.

Methods: We collected data from the program's 29 grantees, funded to provide colorectal cancer screening and diagnostic services to asymptomatic, low-income, and underinsured or uninsured adults aged 50 to 64. We collected data on the dates and results of all screening and diagnostic tests and, for colonoscopies, on whether the cecum was reached, whether bowel preparation was adequate, and endoscopists' recommendations for the next test.

Results: Overall, 82.9% (range among grantees, 50.0%-97.2%) of positive FOBTs/FITs were followed up by colonoscopy; 95.2% of colonoscopies occurred within 180 days of the positive stool test. Cecal intubation rates ranged among grantees from 94.2% to 100%. Adenoma detection rates met recommended threshold levels for almost all grantees. Recommendations for rescreening and surveillance intervals deviated from guidelines in both directions. Of clients with normal colonoscopies, 85.3% (range, 37.7%-99.7%) were told to return in 10 years, as recommended in national guidelines. Of clients with advanced adenomas, 55.2% (range, 20.0%-84.6%) were told to return in 3 years as recommended, 25.4% (range, 3.8%-56.6%) in 5 or more years, and 18.6% (range, 0%-47.2%) in less than 3 years.

Conclusion: Although overall screening quality was good, it varied considerably. Ongoing monitoring to identify performance problems is essential for all colorectal cancer screening activities, so that efforts designed to improve performance can be targeted to individual clinicians.

PubMed Disclaimer

Figures
Figure 1

Twenty-nine grantees in the Centers…

Figure 1

Twenty-nine grantees in the Centers for Disease Control and Prevention’s Colorectal Cancer Control…

Figure 1

Twenty-nine grantees in the Centers for Disease Control and Prevention’s Colorectal Cancer Control Program, 2009–2015. Shading indicates a grantee state. An asterisk indicates a tribal grantee.

Figure 2

Positivity rates for FITs and…

Figure 2

Positivity rates for FITs and FOBTs among clients aged ≥50, by grantee, Colorectal…

Figure 2

Positivity rates for FITs and FOBTs among clients aged ≥50, by grantee, Colorectal Cancer Control Program, 2009–2015. N’s indicate number of tests. A, FIT positivity rates. Only the 18 grantees that recorded ≥30 FITs are shown individually. “All grantees” refers to all grantees, including grantees that had <30 tests. B, FOBT positivity rates. Only the 7 grantees that recorded ≥30 FOBTs are shown individually. “All grantees” refers to all grantees, including the grantees that had <30 tests. Tests for which results were not known were excluded from these analyses. Abbreviations: FIT, fecal immunochemical test; FOBT, fecal occult blood test.