scholarly journals Colorectal cancer screening behaviors of general surgeons and first-degree family members: a survey-based study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Suleyman Utku Celik ◽  
Hasan Gorkem Cay ◽  
Ersin Bayrakdar ◽  
Aysima Ince ◽  
Esra Nur Ince ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Family Members ◽  
High Volume ◽  
Routine Screening ◽  
Care Providers ◽  
Crc Screening ◽  
First Degree Relatives ◽  
General Surgeons ◽  
Low Volume ◽  
Screening Behaviors

Abstract Background Colorectal cancer (CRC) screening rates are low in the general population and among health care providers. The aim of this study was to evaluate the CRC screening practices of general surgeons who provide specialized diagnostic testing and CRC treatment and to examine the CRC screening behaviors of their first-degree family members. Methods A cross-sectional survey was conducted among general surgeons who attended the 21st National Surgical Congress in Turkey held from April 11th to 15th, 2018. The survey included items on demographics, screening-related attitude, CRC screening options, barriers to CRC screening, and surgeons’ annual volumes of CRC cases. Results A total of 530 respondents completed the survey. Almost one-third of the responding surgeons (29.4%, n = 156) were aged over 50 years, among whom approximately half (47.1%, n = 74) reported having undergone CRC screening and preferring a colonoscopy as the screening modality (78.4%). Among general surgeons aged 50 years and older, high-volume surgeons (≥25 CRC cases per year) were more likely to undergo screening compared with low-volume surgeons (< 25 CRC cases per year). The respondents aged below 50 years reported that 56.1% (n = 210) of their first-degree relatives were up-to-date with CRC screening, mostly with colonoscopy. Compared to low-volume surgeons aged below 50 years, high-volume surgeons’ first-degree relatives were more likely to be up-to-date with CRC screening. Conclusion The survey results demonstrated that routine screening for CRC among surgeons and/or their first-degree relatives is currently not performed at the desired level. However, high-volume surgeons are more likely to participate in routine screening.

scholarly journals The importance of colonoscopy bowel preparation for the detection of colorectal lesions and colorectal cancer prevention

2020 ◽  
Vol 08 (05) ◽  
pp. E673-E683 ◽  
Author(s):  
Prateek Sharma ◽  
Carol A. Burke ◽  
David A. Johnson ◽  
Brooks D. Cash
Keyword(s):  
Colorectal Cancer ◽  
Bowel Preparation ◽  
Clinical Importance ◽  
High Volume ◽  
High Quality ◽  
Crc Screening ◽  
Incidence And Mortality ◽  
Low Volume ◽  
Split Dosing ◽  
Bowel Preparations

Abstract Background and study aims Colonoscopy for colorectal cancer (CRC) screening has reduced CRC incidence and mortality and improved prognosis. Optimal bowel preparation and high-quality endoscopic technique facilitate early CRC detection.This review provides a narrative on the clinical importance of bowel preparation for colonoscopy and highlights available bowel preparations. Methods A PubMed search was conducted through June 2019 to identify studies evaluating clinical outcomes, efficacy, safety, and tolerability associated with bowel preparation for CRC screening-related colonoscopy. Results Selecting the optimal bowel preparation regimen is based on considerations of efficacy, safety, and tolerability, in conjunction with individual patient characteristics and preferences. Available bowel preparations include high-volume (4 L) and low-volume (2 L and 1 L), polyethylene glycol (PEG) solutions, sodium sulfate, sodium picosulfate/magnesium oxide plus anhydrous citric acid, sodium phosphate tablets, and the over-the-counter preparations magnesium citrate and PEG-3350. These preparations may be administered as a single dose on the same day or evening before, or as two doses administered the same day or evening before/morning of colonoscopy. Ingesting at least half the bowel preparation on the day of colonoscopy (split-dosing) is associated with higher adequate bowel preparation quality versus evening-before dosing (odds ratio [OR], 2.5; 95 % confidence interval [CI], 1.9−3.4). Conclusions High-quality bowel preparation is integral for optimal CRC screening/surveillance by colonoscopy. Over the last 30 years, patients and providers have gained more options for bowel preparation, including low-volume agents with enhanced tolerability and cleansing quality that are equivalent to 4 L preparations. Split-dosing is preferred for achieving a high-quality preparation.

scholarly journals Center-Level Procedure Volume Does Not Predict Failure-to-Rescue After Severe Complications of Oncologic Colon and Rectal Surgery

2021 ◽  
Author(s):  
Miriam Lillo-Felipe ◽  
Rebecka Ahl Hulme ◽  
Maximilian Peter Forssten ◽  
Gary A. Bass ◽  
Yang Cao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
High Volume ◽  
Cancer Surgery ◽  
Colon And Rectal Surgery ◽  
Surgical Volume ◽  
Failure To Rescue ◽  
Colorectal Cancer Surgery ◽  
Procedure Volume ◽  
Low Volume

Abstract Background The relationship between hospital surgical volume and outcome after colorectal cancer surgery has thoroughly been studied. However, few studies have assessed hospital surgical volume and failure-to-rescue (FTR) after colon and rectal cancer surgery. The aim of the current study is to evaluate FTR following colorectal cancer surgery between clinics based on procedure volume. Methods Patients undergoing colorectal cancer surgery in Sweden from January 2015 to January 2020 were recruited through the Swedish Colorectal Cancer Registry. The primary endpoint was FTR, defined as the proportion of patients with 30-day mortality after severe postoperative complications in colorectal cancer surgery. Severe postoperative complications were defined as Clavien–Dindo ≥ 3. FTR incidence rate ratios (IRR) were calculated comparing center volume stratified in low-volume (≤ 200 cases/year) and high-volume centers (> 200 cases/year), as well as with an alternative stratification comparing low-volume (< 50 cases/year), medium-volume (50–150 cases/year) and high-volume centers (> 150 cases/year). Results A total of 23,351 patients were included in this study, of whom 2964 suffered severe postoperative complication(s). Adjusted IRR showed no significant differences between high- and low-volume centers with an IRR of 0.97 (0.75–1.26, p = 0.844) in high-volume centers in the first stratification and an IRR of 2.06 (0.80–5.31, p = 0.134) for high-volume centers and 2.15 (0.83–5.56, p = 0.116) for medium-volume centers in the second stratification. Conclusion This nationwide retrospectively analyzed cohort study fails to demonstrate a significant association between hospital surgical volume and FTR after colorectal cancer surgery. Future studies should explore alternative characteristics and their correlation with FTR to identify possible interventions for the improvement of quality of care after colorectal cancer surgery.

scholarly journals Linking lab, program, and administrative data to provide comprehensive colorectal cancer screening status of patients to primary care providers in Calgary, Alberta

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Jessica Law ◽  
Jeannine Viczko ◽  
Robert Hilsden ◽  
Emily McKenzie ◽  
Mark Watt ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Primary Care Providers ◽  
Care Providers ◽  
Summary Report ◽  
Positive Screen ◽  
Crc Screening

IntroductionColorectal cancer (CRC) screening is associated with significant reductions in burden, mortality and cost. Primary care providers in Alberta do not have access to integrated CRC testing histories for patients. Providing this information will support CRC screening among patients at average and high risk, follow-up of abnormal tests, and surveillance. Objectives and ApproachCalgary Laboratory Services, Colon Cancer Screening Centre, Alberta Cancer Registry, and endoscopy data were linked to create a comprehensive CRC screening history at the patient level. Based on screening histories and the current Clinical Practice Guideline, an algorithm was created to determine CRC screening statuses with the aim of providing accurate screening rates when linked to primary care provider patient panels. Results from the linkage are designed to be incorporated into clinic and EMR workflow processes to support adherence to evidence-based screening recommendations at the point of care. ResultsA comprehensive assessment of screening status was determined by integrating Fecal Immunochemical Test (FIT) and colonoscopy data. Among a sample cohort, patients were identified as being due for screening with FIT, requiring follow-up for a positive FIT test, or requiring appropriate surveillance for a positive-screen or abnormal colonoscopy findings. A summary report, actionable list, and resources were developed to convey findings. The summary report displayed CRC screening rates for a provider’s panel. The actionable list provided CRC screening statuses for each patient aged 40 to 84 indicating patients due for screening with FIT, for follow-up of positive FIT, or for surveillance colonoscopy. The resources were developed to support quality improvement for colorectal cancer screening for patients. Conclusion/ImplicationsThe data linkages and algorithm provide comprehensive CRC screening, follow-up, and surveillance information that could support guideline-adherent screening, increase screening rates, reduce duplication or unnecessary testing, and provide primary care providers with timely and robust information to support clinical decisions for individuals inside and outside of the target screening population.

scholarly journals Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality Improvement Interventions

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Jennifer M. Weiss ◽  
Perry J. Pickhardt ◽  
Jessica R. Schumacher ◽  
Aaron Potvien ◽  
David H. Kim ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Quality Improvement ◽  
Primary Care Providers ◽  
Care Providers ◽  
Provider Perceptions ◽  
Crc Screening ◽  
Improvement Interventions ◽  
Quality Improvement Interventions ◽  
Screening Barriers

Aims. Colorectal cancer (CRC) screening is underutilized. Increasing CRC screening rates requires interventions targeting multiple barriers at each level of the healthcare organization (patient, provider, and system). We examined groups of primary care providers (PCPs) based on perceptions of screening barriers and the relationship to CRC screening rates to inform approaches for conducting barrier assessments prior to designing and implementing quality improvement interventions.Methods. We conducted a retrospective cohort study linking EHR and survey data. PCPs with complete survey responses for questions addressing CRC screening barriers were included (N=166PCPs; 39,430 patients eligible for CRC screening). Cluster analysis identified groups of PCPs. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for predictors of membership in one of the PCP groups.Results. We found two distinct groups: (1) PCPs identifying multiple barriers to CRC screening at patient, provider, and system levels (N=75) and (2) PCPs identifying no major barriers to screening (N=91). PCPs in the top half of CRC screening performance were more likely to identify multiple barriers than the bottom performers (OR, 4.14; 95% CI, 2.43–7.08).Conclusions. High-performing PCPs can more effectively identify CRC screening barriers. Targeting high-performers when conducting a barrier assessment is a novel approach to assist in designing quality improvement interventions for CRC screening.

scholarly journals Influence of Individual Surgeon Volume on Oncological Outcome of Colorectal Cancer Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Marleen Buurma ◽  
Hidde M. Kroon ◽  
Marlies S. Reimers ◽  
Peter A. Neijenhuis
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Disease Free Survival ◽  
High Volume ◽  
Free Survival ◽  
Significant Difference ◽  
Low Volume ◽  
The Impact ◽  
Disease Free

Background. Surgery performed by a high-volume surgeon improves short-term outcomes. However, not much is known about long-term effects. Therefore we performed the current study to evaluate the impact of high-volume colorectal surgeons on survival.Methods. We conducted a retrospective analysis of our prospectively collected colorectal cancer database between 2004 and 2011. Patients were divided into two groups: operated on by a high-volume surgeon (>25 cases/year) or by a low-volume surgeon (<25 cases/year). Perioperative data were collected as well as follow-up, recurrence rates, and survival data.Results. 774 patients underwent resection for colorectal malignancies. Thirteen low-volume surgeons operated on 453 patients and 4 high-volume surgeons operated on 321 patients. Groups showed an equal distribution for preoperative characteristics, except a higher ASA-classification in the low-volume group. A high-volume surgeon proved to be an independent prognostic factor for disease-free survival in the multivariate analysisP=0.04. Although overall survival did show a significant difference in the univariate analysisP<0.001it failed to reach statistical significance in the multivariate analysisP=0.09.Conclusions. In our study, a higher number of colorectal cases performed per surgeon were associated with longer disease-free survival. Implementing high-volume surgery results in improved long-term outcome following colorectal cancer.

scholarly journals Primary care providers’ beliefs and practices on colorectal cancer screening in Kuwait

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E L Tolma ◽  
S M Aljunid ◽  
M N Amrizal ◽  
J Longenecker ◽  
A Al-Basmy ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Health System ◽  
Screening Test ◽  
Primary Care Providers ◽  
Screening Tests ◽  
Care Providers ◽  
Beliefs And Practices ◽  
Crc Screening

Abstract Background Colorectal cancer (CRC) is a major public health issue in the Arab region. In Kuwait, CRC is the second most frequent cancer, with an age-standardized (world) incidence rate of 13.2 cases/100,000 in 2018. Despite the national efforts to promote CRC screening the current participation rate is very low (5 to 17%). Primary Care Providers (PCPs) are considered as the gatekeepers of cancer screening globally. This is one of the first studies in Kuwait that examined the current beliefs/practices of PCPs on CRC screening. Methods This cross-sectional study was conducted at governmental primary care centers in Kuwait from 2015-2017. Of 564 PCPs invited to participate from all centers, 255 completed the self-administered questionnaires. The 14-page survey contained 75 questions on PCPs’ beliefs and practices of CRC screening. Data were analyzed by using descriptive statistics. Results The study sample consisted primarily of females (52.0%) and non-Kuwaiti (79%) physicians, with mean age =43.3 (SD: 11.2) years. Most respondents (92%) believed that colonoscopy is the most effective screening tool. The majority (78%) reported that they recommend CRC screening to their patients, with colonoscopy as the most frequent modality (87%) followed by the Faecal Occult Blood Test (FOBT) (52%). Around 40% of the respondents stated that they did not have time to discuss CRC screening with their patients. The majority (72%) believed that their patients did not complete their CRC screening tests. Health system related barriers included difficulties in obtaining test results from the gastroenterologist (61.4%), ordering follow-up test after a positive screening test (50.6%) and shortage of trained staff to conduct the screening test (44.2%). Conclusions A majority of PCPs in Kuwait recommend CRC screening to their patients, but not all patients follow through their recommendation. More research is needed to find out how to further enhance patient uptake of CRC screening. Key messages Colonoscopy is the most frequent screening CRC modality used in Kuwait. Health system related factors can be important future intervention targets to promote CRC screening.

Validation of Self-reported Colorectal Cancer (CRC) Screening in a Study of Ethnically Diverse First-Degree Relatives of CRC Cases

2008 ◽  
Vol 17 (4) ◽  
pp. 791-798 ◽  
Author(s):  
Roshan Bastani ◽  
Beth A. Glenn ◽  
Annette E. Maxwell ◽  
Patricia A. Ganz ◽  
Cynthia M. Mojica ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Ethnically Diverse ◽  
Crc Screening ◽  
First Degree Relatives

scholarly journals What’s the “Secret Sauce”? How Implementation Variation Affects the Success of Colorectal Cancer Screening Outreach

2020 ◽  
Author(s):  
Jennifer Coury ◽  
Edward J. Miech ◽  
Patricia Styer ◽  
Amanda F. Petrik ◽  
Kelly E. Coates ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Care Providers ◽  
Descriptive Analysis ◽  
Care Providers ◽  
Screening Rate ◽  
Crc Screening ◽  
Fecal Immunochemical Testing

Abstract Background Mailed fecal immunochemical testing (FIT) programs can improve colorectal cancer (CRC) screening rates, but health systems often vary implementation (i.e., adapt) these programs for their organizations. A health insurance plan implemented a mailed FIT program (named BeneFIT) and allowed participating health systems to adapt the program. This mixed-methods study explored which program adaptations might have achieved higher screening rates.Methods We used a multi-method approach. First, we conducted a descriptive analysis of CRC screening rates by key health system characteristics and program adaptations. Second, we applied Configurational Comparative Methods (CCMs) to determine potential explanatory factors consistent with higher screening rates. The main outcome measure was CRC screening rates.Results Seventeen health systems took part in at least one year of BeneFIT. The overall screening completion rate was 20% (4–28%) in Year 1, and 25% (12–35%) in Year 2 of the program. Health systems that used two or more adaptations had higher screening rates, and no single adaptation clearly led to higher screening rates. In Year 1, smaller systems (having < 2 clinics) with phone reminders (n = 2) met the implementation success threshold (≥ 19% screening rate) while larger systems were successful when offering a patient incentive (n = 4), scrubbing mailing lists (n = 4), or allowing mailed FIT returns with no other adaptations (n = 1). In Year 2, large systems (> 2 clinics) were successful with a phone reminder (n = 4) or a patient incentive (n = 3). Of the 10 systems that implemented BeneFIT in both years, seven improved in Year 2.Conclusions Health systems can choose between many adaptations and successfully implement a health plan’s mailed FIT program. Screening completion rates are positively associated with the number of adaptations implemented by a health system. Health system size emerged as an important contextual factor, with different solutions for larger than smaller health systems.Contributions to the Literature· Our paper analyzes adaptations that enable health care providers to implement mailed fecal immunochemical testing (FIT) programs in delivery systems.· Our results explore which adaptations made by health systems to mailed FIT programs are related to screening rate improvements. Our analysis shows that a health system’s organizational characteristics in combination with the adaptations themselves may affect resulting CRC screening rates and implementation.· Our paper describes different pathways that health care organizations can use to implement CRC screening outreach to improve the health of their populations. We show results of implementation flexibility and customizing CRC screening outreach to particular clinic environments.

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