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Showing content from https://pubmed.ncbi.nlm.nih.gov/25073625/ below:

Follow-up to abnormal cancer screening tests: considering the multilevel context of care

Review

Affiliations

• ¹ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina. zapka@musc.edu.
• ² Clinical Research Directorate/CMRP, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland.
• ³ Process of Care Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.

• PMID: 25073625
• PMCID: PMC4191903
• DOI: 10.1158/1055-9965.EPI-14-0454

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Review

Jane M Zapka et al. Cancer Epidemiol Biomarkers Prev. 2014 Oct.

• ¹ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina. zapka@musc.edu.
• ² Clinical Research Directorate/CMRP, Leidos Biomedical Research, Inc., Frederick National Laboratory for Cancer Research, Frederick, Maryland.
• ³ Process of Care Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.

• PMID: 25073625
• PMCID: PMC4191903
• DOI: 10.1158/1055-9965.EPI-14-0454

Item in Clipboard

The call for multilevel interventions to improve the quality of follow-up to abnormal cancer screening has been out for a decade, but published work emphasizes individual approaches, and conceptualizations differ regarding the definition of levels. To investigate the scope and methods being undertaken in this focused area of follow-up to abnormal tests (breast, colon, cervical), we reviewed recent literature and grants (2007-2012) funded by the National Cancer Institute. A structured search yielded 16 grants with varying definitions of "follow-up" (e.g., completion of recommended tests, time to diagnosis); most included minority racial/ethnic group participants. Ten grants concentrated on measurement/intervention development and 13 piloted or tested interventions (categories not mutually exclusive). All studies considered patient-level factors and effects. Although some directed interventions at provider levels, few measured group characteristics and effects of interventions on the providers or levels other than the patient. Multilevel interventions are being proposed, but clarity about endpoints, definition of levels, and measures is needed. The differences in the conceptualization of levels and factors that affect practice need empirical exploration, and we need to measure their salient characteristics to advance our understanding of how context affects cancer care delivery in a changing practice and policy environment.

©2014 American Association for Cancer Research.

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