2,620 research outputs found
Optimizing patient risk stratification for colonoscopy screening and surveillance of colorectal cancer: The role for linked data
No abstract available for this article
Recommended from our members
A Multi-Level Fit-Based Quality Improvement Initiative to Improve Colorectal Cancer Screening in a Managed Care Population.
IntroductionColorectal cancer (CRC) is a common but largely preventable disease with suboptimal screening rates despite national guidelines to screen individuals age 50-75. Single-component interventions aimed to improve screening uptake only modestly improve rates; data suggest that multi-modal approaches may be more effective.MethodsWe designed, implemented, and evaluated the impact of a multi-modal intervention on CRC screening uptake among unscreened patients in a large managed care population. Patient-level components included a mailed letter with education about screening options and pre-colonoscopy telephone counseling. For providers, we facilitated communication of screening test results and work-flow for abnormal results. System-level modifications included establishment of a patient navigator, expedited work-up for abnormal results, and stream-lined colonoscopy scheduling. We measured the rate of screening uptake overall, screening uptake by modality, change in the proportion of the population screened, and positive fecal immunochemical test (FIT) follow-up rates in the 1-year study period.ResultsThere were 5093 patients in the intervention cohort. Of these, 33.2% participated in FIT or colonoscopy screening within 1 year of the mailing. A total of 1078 (21.2%) participants completed a FIT and 611 (12.0%) completed a screening colonoscopy. The screening rate in the managed care population increased from 65.1 to 76.6%. Fifty-nine patients (5.5%) had a positive FIT, of which 30 (50.8%) completed a diagnostic colonoscopy.ConclusionMulti-modal interventions can result in substantial improvement in CRC screening uptake in large and diverse managed care populations.Translational impactHealth systems should shift their focus from single-level to multi-level interventions when addressing barriers to CRC screening
Population screening for colorectal cancer means getting FIT:the past, present, and future of colorectal cancer screening using the fecal immunochemical test for hemoglobin (FIT)
Fecal immunochemical tests for hemoglobin (FIT) are changing the manner in which colorectal cancer (CRC) is screened. Although these tests are being performed worldwide, why is this test different from its predecessors? What evidence supports its adoption? How can this evidence best be used? This review addresses these questions and provides an understanding of FIT theory and practices to expedite international efforts to implement the use of FIT in CRC screening
Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines
The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options
RELATIONSHIPS BETWEEN MASCULINITY BELIEFS AND COLORECTAL CANCER SCREENING IN MALE VETERANS
Colorectal cancer (CRC) is the third most common cancer diagnosed and the third most common cause of cancer deaths among men in the United States. Although CRC screening tests can reduce CRC incidence and mortality, men’s current rates of CRC screening fall below screening objectives. Results from qualitative studies have suggested masculinity to be a potential barrier to CRC screening as some men may find endoscopic screening procedures to breach masculinity norms. In prior studies, masculinity beliefs have been associated with preventive health behaviors as well as risk behaviors among men. However, to the author’s knowledge, no other quantitative studies have examined the relationship between masculinity and CRC screening adherence. The current study aimed to understand the relationship between three aspects of masculinity (i.e., self-reliance, risk-taking, and heterosexual self-presentation), health beliefs, participant characteristics, and CRC screening adherence. It was hypothesized that the three aspects of masculinity would be inversely associated with CRC screening adherence. Data were collected from 350 men aged 51-75 at average risk for CRC who were accessing primary care services at a Veterans Affairs Medical Center. Of the 350 consenting individuals, data from 327 participants were included in study analyses. Of those 327 participants, 213 individuals were adherent to CRC screening guidelines and the remaining 114 were non-adherent. Correlational and logistic regression analyses were utilized to examine associations between aspects of masculinity and CRC screening adherence. Conditional process analyses were used to examine whether health belief variables (i.e., trust in physician and cancer fear) mediated the relationships between certain aspects of masculinity and CRC screening adherence. Next, participant characteristics (i.e., race, age, and length of relationship between the patient and his primary care provider) were examined as potential moderators of certain relationships in the models utilizing conditional process analyses. In addition, a hierarchical logistic regression analysis was utilized to examine whether the three aspects of masculinity predicted CRC screening adherence above and beyond the predictive value of variables that have predicted CRC screening adherence in prior studies (i.e., race, age, education, physician recommending CRC screening, and family/friend recommending CRC screening). Furthermore, logistic regression analyses were used to examine the extent to which the three aspects of masculinity predicted the receipt of stool blood testing and endoscopic screening. Results suggested that none of the three masculinity variables were significantly associated with CRC screening adherence. In addition, health beliefs did not mediate the proposed relationships between aspects of masculinity and CRC screening adherence, and participant characteristics did not moderate relations between certain mediators and outcome variables. Potential explanations for study results and future directions are discussed. Prospective and longitudinal research studies that recruit participants from diverse backgrounds are required to better understand relationships among study variables
- …