Meaningful reporting in primary care: An evaluation of the screening activity report.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 173-173
Author(s):  
Nicki Cunningham ◽  
Christine Stogios ◽  
Shama Umar ◽  
Dafna Carr ◽  
Jason Garay ◽  
...  

173 Background: Cancer Care Ontario (CCO) developed the ColonCancerCheck Screening Activity Report (CCC SAR) as a supplementary tool for primary care physicians (PCPs) who are part of a patient enrolment model in Ontario, Canada to support them in increasing their colorectal cancer screening rates and appropriate follow-ups. The report provides PCPs with a summary of their eligible patients’ colorectal cancer screening-related history and was designed with the intent of supporting both population health management and opportunistic screening. Delivered through an online platform, the SAR offers PCPs access to data to facilitate quality cancer screening practices aligned with CCO’s evidence-based clinical guidelines. Methods: The report leverages provincial datasets to summarize screening activities on a per-patient level and actionable follow-up recommendations based on CCO’s clinical guidelines. To evaluate the impact of the reports on colorectal screening participation rates, a Generalized Estimating Equation model was used. Results: Results on the report’s impact on colorectal cancer screening participation rates from the first release (February 2013) are promising. By identifying for PCPs which patients are overdue for screening, the SAR demonstrated a modest and statistically significant 6% increased likelihood of patients being screened using a Fecal Occult Blood Test (FOBT) if their PCP was registered to access the online report, compared to patients of unregistered PCPs. The impact to screening increased to 25% when comparing registered PCPs who logged in and viewed their SAR to registered PCPs who did not login; however, this analysis is at a greater risk of a volunteer bias. Such PCPs may be more likely to screen their patients independent of viewing their SAR. Conclusions: By equipping PCPs with patient-level data grounded in CCO’s evidence-based clinical guidelines, the SAR is innovative in its potential to increase screening rates and the appropriate follow-up of abnormal results. The successful launch of two online CCC SARs, sharing meaningful colorectal cancer screening data to frontline providers, has driven the report’s expansion to include breast and cervical cancer screening data in spring of 2014.

2017 ◽  
Vol 28 ◽  
pp. iii90-iii91
Author(s):  
Jérôme Viguier ◽  
Jean-François Morere ◽  
Xavier Pivot ◽  
Alexis B. Cortot ◽  
Jean-Yves Blay ◽  
...  

2017 ◽  
Vol 55 (12) ◽  
pp. 1307-1312 ◽  
Author(s):  
Tianzuo Zhan ◽  
Thomas Hielscher ◽  
Asmé Bilge ◽  
Thomas Giese ◽  
Christoph Schäfer ◽  
...  

Abstract Background and Aim Participation rates in the German colorectal cancer screening program are low. Starting in 2013, a large health insurance plan in Bavaria, Germany, is sending an additional invitation letter to insured individuals when they turn 50 or 55 years and become eligible for participation in the program. The letter provides detailed information on colorectal cancer screening. We assessed the impact of the invitation letter on utilization rates. Methods Insurance claims data of a total of 48 343 individuals who had turned 50 or 55 years between 2012 to 2014 were reviewed for utilization rates of screening colonoscopy and fecal blood tests. Utilization rates 1 year prior (2012) and 2 years after introduction of the invitation letter (2013 and 2014) were compared. Furthermore, providers of colorectal cancer screening were determined. Results Within 6 months after turning 50 or 55 years, 8.8 – 10.2 % of all insured individuals participated in colorectal cancer screening, with the majority being females. After the introduction of the invitation letter, a moderate increase in participation rates could be observed (increase to 109 % [RR 101.7 – 117.3 %, p = 0.02] in 2014). The uptake rate of screening colonoscopy was significantly higher in recipients of the letter (increase to 138.4 % [RR 110.4 – 173.8 %, p = 0.0043] in 2013 and to 149 % [RR 119.5 – 186.3 %, p = 0.0003] in 2014). Furthermore, a significantly higher proportion of general practitioners and gastroenterologists provided colorectal cancer screening in individuals receiving the invitation letter. Conclusions Introduction of an invitation letter can improve participation rates for colorectal cancer screening.


Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1129
Author(s):  
Audrius Dulskas ◽  
Tomas Poskus ◽  
Inga Kildusiene ◽  
Ausvydas Patasius ◽  
Rokas Stulpinas ◽  
...  

We aimed to report the results of the implementation of the National Colorectal Cancer (CRC) Screening Program covering all the country. The National Health Insurance Fund (NHIF) reimburses the institutions for performing each service; each procedure within the program has its own administrative code. Information about services provided within the program was retrieved from the database of NHIF starting from the 1 January 2014 to the 31 December 2018. Exact date and type of all provided services, test results, date and results of biopsy and histopathological examination were extracted together with the vital status at the end of follow-up, date of death and date of emigration when applicable for all men and women born between 1935 and 1968. Results were compared with the guidelines of the European Union for quality assurance in CRC screening and diagnosis. The screening uptake was 49.5% (754,061 patients) during study period. Participation rate varied from 16% to 18.1% per year and was higher among women than among men. Proportion of test-positive and test-negative results was similar during all the study period—8.7% and 91.3% annually. Between 9.2% and 13.5% of test-positive patients received a biopsy of which 52.3–61.8% were positive for colorectal adenoma and 4.6–7.3% for colorectal carcinoma. CRC detection rate among test-positive individuals varied between 0.93% and 1.28%. The colorectal cancer screening program in Lithuania coverage must be improved. A screening database is needed to systematically evaluate the impact and performance of the national CRC screening program and quality assurance within the program.


2021 ◽  
Vol 124 (9) ◽  
pp. 1516-1523
Author(s):  
Lindy M. Kregting ◽  
Sylvia Kaljouw ◽  
Lucie de Jonge ◽  
Erik E. L. Jansen ◽  
Elleke F. P. Peterse ◽  
...  

Abstract Background Many breast, cervical, and colorectal cancer screening programmes were disrupted due to the COVID-19 pandemic. This study aimed to estimate the effects of five restart strategies after the disruption on required screening capacity and cancer burden. Methods Microsimulation models simulated five restart strategies for breast, cervical, and colorectal cancer screening. The models estimated required screening capacity, cancer incidence, and cancer-specific mortality after a disruption of 6 months. The restart strategies varied in whether screens were caught up or not and, if so, immediately or delayed, and whether the upper age limit was increased. Results The disruption in screening programmes without catch-up of missed screens led to an increase of 2.0, 0.3, and 2.5 cancer deaths per 100 000 individuals in 10 years in breast, cervical, and colorectal cancer, respectively. Immediately catching-up missed screens minimised the impact of the disruption but required a surge in screening capacity. Delaying screening, but still offering all screening rounds gave the best balance between required capacity, incidence, and mortality. Conclusions Strategies with the smallest loss in health effects were also the most burdensome for the screening organisations. Which strategy is preferred depends on the organisation and available capacity in a country.


2017 ◽  
Vol 25 (3) ◽  
pp. 126-133 ◽  
Author(s):  
Deborah Saraste ◽  
Daniel J Öhman ◽  
Marika Sventelius ◽  
K Miriam Elfström ◽  
Johannes Blom ◽  
...  

Objectives To assess patterns and probabilities of participation in multiple rounds of colorectal cancer screening. Methods All individuals who were invited to participate in population-based colorectal cancer screening in the Stockholm-Gotland region in Sweden between 1 January 2008 and 30 September 2015 were included in the study. Guaiac-based faecal occult blood testing was used. All individuals invited to the three first consecutive screening rounds were included in the analysis. Results There were 346,168 individuals eligible for invitation to screening. The average participation rate during the follow-up period was 60%. Eligible individuals could be invited 1–4 times, depending on age at first invitation. Of 48,959 individuals invited to the three first consecutive rounds of screening, 71% participated at least once, and 50% participated in all three rounds. Participation at first invitation was a predictor for participation in subsequent rounds, and the likelihood of continuous participation following participation in the first round was 84%. Of those who attended the first and second rounds, 93% also participated in the third round. Similar patterns of consistency were seen among non-participants. For individuals not participating in the first screening round, the likelihood of consistent non-participation was 71. Conclusions Participation in the first round of screening is a strong predictor for participation in subsequent rounds. Therefore, reducing barriers for initial participation is a key for achieving consistent participation over several rounds in organized colorectal cancer screening programmes.


2017 ◽  
Author(s):  
Pernille Gabel ◽  
Pia Kirkegaard ◽  
Mette Bach Larsen ◽  
Adrian Edwards ◽  
Berit Andersen

BACKGROUND Citizens with lower educational attainments (EA) take up colorectal cancer screening to a lesser degree, and more seldom read and understand conventional screening information than citizens with average EAs. The information needs of citizens with lower EA are diverse, however, with preferences ranging from wanting clear recommendations to seeking detailed information about screening. Decision aids have been developed to support citizens with lower EA in making informed decisions about colorectal cancer screening participation, but none embrace diverse information needs. OBJECTIVE The aim of this study was to develop a self-administered decision aid for participation in fecal immunochemical test–based colorectal cancer screening. The decision aid should be tailored to citizens with lower EA and should embrace diverse information needs. METHODS The Web-based decision aid was developed according to an international development framework, with specific steps for designing, alpha testing, peer reviewing, and beta testing the decision aid. In the design phase, a prototype of the decision aid was developed based on previous studies about the information needs of lower EA citizens and the International Patient Decision Aid Standards guidelines. Alpha testing was conducted using focus group interviews and email correspondence. Peer review was conducted using email correspondence. Both tests included both lower EA citizens and health care professionals. The beta testing was conducted using telephone interviews with citizens with lower EA. Data were analyzed using thematic analysis. RESULTS The developed decision aid presented information in steps, allowing citizens to read as much or as little as wanted. Values clarification questions were included after each section of information, and answers were summarized in a “choice-indicator” on the last page, guiding the citizens toward a decision about screening participation. Statistics were presented in both natural frequencies, absolute risk formats and graphically. The citizens easily and intuitively navigated around the final version of the decision aid and stated that they felt encouraged to think about the benefits and harms of colorectal cancer screening without being overloaded with information. They found the decision aid easy to understand and the text of suitable length. The health care professionals agreed with the citizens on most parts; however, concerns were raised about the length and readability of the text. CONCLUSIONS We have developed a self-administered decision aid presenting information in steps. We involved both citizens and health care professionals to target the decision aid for citizens with lower EA. This decision aid represents a new way of communicating detailed information and may be able to enhance informed choices about colorectal cancer screening participation among citizens with lower EA.


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