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

Showing content from https://pubmed.ncbi.nlm.nih.gov/10511591/ below:

Diagnostic testing following fecal occult blood screening in the elderly

Affiliations

• ¹ Veterans Affairs Medical Center, White River Junction, VT. jon.d.lurie@dartmouth.edu

• PMID: 10511591
• DOI: 10.1093/jnci/91.19.1641

Item in Clipboard

J D Lurie et al. J Natl Cancer Inst. 1999.

• ¹ Veterans Affairs Medical Center, White River Junction, VT. jon.d.lurie@dartmouth.edu

• PMID: 10511591
• DOI: 10.1093/jnci/91.19.1641

Item in Clipboard

Background: Screening with a fecal occult blood test (FOBT) has been shown to reduce colorectal cancer mortality in controlled trials. Recently, Medicare approved payment for FOBT screening. We evaluated the pattern of diagnostic testing following the initial FOBT in elderly Medicare beneficiaries. Such follow-up testing would in the long run influence both the cost and the benefit of widespread use of FOBT.

Methods: Using Medicare's National Claims History System, we identified 24 246 Americans 65 years old or older who received FOBT at physician visits between January 1 and April 30, 1995. Prior to FOBT, these people had no evidence of any conditions for which FOBT might be used diagnostically. We examined relevant diagnostic testing in this cohort during the subsequent 8 months and determined what proportion of those received an evaluation recommended by the American College of Physicians.

Results: For every 1000 Medicare beneficiaries who received FOBT, 93 (95% confidence interval = 89-96 per 1000) had positive findings and relevant testing in the subsequent 8 months. Of these, 34% had the recommended evaluation of either colonoscopy or flexible sigmoidoscopy with an air-contrast barium enema. Another 34% received a partial colonic evaluation with either flexible sigmoidoscopy or a barium enema. The remaining 32% received other gastrointestinal (GI) testing without evaluation of the colonic lumen: computed tomography or magnetic resonance imaging of the abdomen (15%), upper GI series (10%), carcinoembryonic antigen (7%), and upper endoscopy (2%). Restricting the analysis to testing performed within 2 months of the initial FOBT yielded similar results.

Conclusion: Following FOBT, many Medicare beneficiaries get further diagnostic testing, but only a small proportion receives the recommended evaluation. With this pattern of practice, population screening is likely to be more costly and less effective than estimated from controlled trials.

PubMed Disclaimer

• Physician-reported reasons for limited follow-up of patients with a positive fecal occult blood test screening result.

  Baig N, Myers RE, Turner BJ, Grana J, Rothermel T, Schlackman N, Weinberg DS. Baig N, et al. Am J Gastroenterol. 2003 Sep;98(9):2078-81. doi: 10.1111/j.1572-0241.2003.07575.x. Am J Gastroenterol. 2003. PMID: 14499791

• Lack of follow-up after fecal occult blood testing in older adults: inappropriate screening or failure to follow up?

  Carlson CM, Kirby KA, Casadei MA, Partin MR, Kistler CE, Walter LC. Carlson CM, et al. Arch Intern Med. 2011 Feb 14;171(3):249-56. doi: 10.1001/archinternmed.2010.372. Epub 2010 Oct 11. Arch Intern Med. 2011. PMID: 20937917 Free PMC article.

• Geographic variation among Medicare beneficiaries in the use of colorectal carcinoma screening procedures.

  Cooper GS, Koroukian SM. Cooper GS, et al. Am J Gastroenterol. 2004 Aug;99(8):1544-50. doi: 10.1111/j.1572-0241.2004.30902.x. Am J Gastroenterol. 2004. PMID: 15307875

• Fecal occult blood test screening for colorectal cancer.

  Bond JH. Bond JH. Gastrointest Endosc Clin N Am. 2002 Jan;12(1):11-21. doi: 10.1016/s1052-5157(03)00054-0. Gastrointest Endosc Clin N Am. 2002. PMID: 11916154 Review.

• Screening for colorectal cancer.

  Saliangas K. Saliangas K. Tech Coloproctol. 2004 Nov;8 Suppl 1:s10-3. doi: 10.1007/s10151-004-0098-9. Tech Coloproctol. 2004. PMID: 15655587 Review.

• Patient and physician reminders to promote colorectal cancer screening: a randomized controlled trial.

  Sequist TD, Zaslavsky AM, Marshall R, Fletcher RH, Ayanian JZ. Sequist TD, et al. Arch Intern Med. 2009 Feb 23;169(4):364-71. doi: 10.1001/archinternmed.2008.564. Arch Intern Med. 2009. PMID: 19237720 Free PMC article. Clinical Trial.

• Impact of organised programs on colorectal cancer screening.

  Eisinger F, Cals L, Calazel-Benque A, Blay JY, Coscas Y, Dolbeault S, Namer M, Pivot X, Rixe O, Serin D, Roussel C, Morère JF; EDIFICE committee. Eisinger F, et al. BMC Cancer. 2008 Apr 15;8:104. doi: 10.1186/1471-2407-8-104. BMC Cancer. 2008. PMID: 18412950 Free PMC article.

• Promoting colorectal cancer screening among Haitian Americans.

  Coughlin SS, Lubetkin EI, Hay JL, Raphael R, Smith SA. Coughlin SS, et al. J Ga Public Health Assoc. 2015;5(2):149-152. J Ga Public Health Assoc. 2015. PMID: 26819972 Free PMC article.

• A survey of individual preference for colorectal cancer screening technique.

  Nelson RL, Schwartz A. Nelson RL, et al. BMC Cancer. 2004 Nov 8;4:76. doi: 10.1186/1471-2407-4-76. BMC Cancer. 2004. PMID: 15533242 Free PMC article.

• Low Rates of Colonoscopy Follow-up After a Positive Fecal Immunochemical Test in a Medicaid Health Plan Delivered Mailed Colorectal Cancer Screening Program.

  Green BB, Baldwin LM, West II, Schwartz M, Coronado GD. Green BB, et al. J Prim Care Community Health. 2020 Jan-Dec;11:2150132720958525. doi: 10.1177/2150132720958525. J Prim Care Community Health. 2020. PMID: 32912056 Free PMC article.

RetroSearch is an open source project built by @garambo | Open a GitHub Issue

Search and Browse the WWW like it's 1997 | Search results from DuckDuckGo

HTML: 3.2 | Encoding: UTF-8 | Version: 0.7.3