scholarly journals Socioeconomic Disparity Trends in Cancer Screening Among Women After Introduction of National Quality Indicators

2021 ◽  
Vol 19 (5) ◽  
pp. 396-404
Author(s):  
Yiska Loewenberg Weisband ◽  
Luz Torres ◽  
Ora Paltiel ◽  
Yael Wolf Saggy ◽  
Ronit Calderon-Margalit ◽  
...  
2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 144s-144s
Author(s):  
N. Baines ◽  
C. Anderson ◽  
P. Tobin

Background and context: Lung cancer screening with low-dose computed tomography is recommended by the Canadian Task Force on Preventive Health Care for individuals at high risk. While no organized lung cancer screening programs currently exist, several Canadian jurisdictions have begun to plan for program implementation with pilot programs, studies, or business cases. Aim: The Canadian Partnership Against Cancer (the Partnership) has supported lung cancer screening activities by initiating a series of projects to promote lung health in Canada. Strategy/Tactics: The Partnership responded to emerging evidence on lung cancer screening with the establishment of the Pan-Canadian Lung Cancer Screening Network (PLCSN) in 2012. The PLCSN brings together key stakeholders from across Canada to promote pan-Canadian collaboration and serves as a national platform for knowledge exchange. Program/Policy process: One of the first priorities of the PLCSN was the development of a consensus statement-based Lung Cancer Screening Framework for Canada in 2014. The Framework outlines key considerations for lung cancer screening programs, including screening eligibility, radiologic testing, pathology quality and reporting, diagnostic treatment and follow-up, and the inclusion of smoking cessation interventions. As the development of the Framework drew to completion, the second priority of the PLCSN was the development of national quality indicators for lung cancer screening. An initial set of ten national-level lung cancer screening quality indicators was developed for national reporting. Most recently, the PLCSN developed a list of five quality-related lung cancer screening questions that should be explored in advance of the widespread implementation of lung cancer screening programs. These considerations included eligibility, enrollment, smoking cessation, nodule management and the effect of lung cancer screening programs on projected lung cancer mortality. Other Partnership initiatives to promote lung health include health economic modeling for lung cancer screening and collecting data on evidence-based smoking cessation programs. Outcomes: These initiatives have aligned pan-Canadian lung cancer screening efforts to facilitate knowledge sharing and resource efficiency, standardization of data collection and reporting, and acceleration of lung cancer screening in Canada. As of January 2018, four provinces have completed business cases, one province has implemented a pilot study, and three trials are ongoing across the country. Partnership initiatives and resources were used by several jurisdictions to inform the development of lung health activities. What was learned: By initiating these activities in advance of organized lung cancer screening programs, the Partnership has contributed to the evidence base on best practices in lung cancer screening that will be necessary for successful program implementation.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Gallagher ◽  
C Astley ◽  
E Thomas ◽  
R Zecchin ◽  
C Ferry ◽  
...  

Abstract Background/Introduction Comprehensive exercise-based cardiac rehabilitation (CR) has well-established efficacy and effectiveness for improving patients' outcomes. There is substantial variability in terms of clinical effectiveness and quality measurement of CR programs internationally which limits service improvement initiatives. In Australia in 2018 a the Australian Cardiovascular Health and Rehabilitation Association (ACRA) and the National Heart Foundation of Australia (NHFA) combined forces to develop nationally-agreed, internationally-consistent, locally-relevant quality indicators (QI). Purpose To provide a minimum set of standardised national-level QI that should be collected and reported on by CR programs to determine the quality of delivery and associated outcomes, benchmark performance and support improvement processes. Methods We formed the National Cardiac Rehabilitation Measurement (NCRM) Taskforce led by ACRA and NHF and used the National Institute for Health and Care Excellence (NICE) UK guidelines to develop high quality QIs. The process included topic overview, prioritising areas for quality improvement, drafting and consultation, validation and consistency checking. Results Eleven preliminary QIs were circulated for ranking and comment to all ACRA members (predominately multidisciplinary CR providers) (68 responses), and to leading national multidisciplinary CR experts from cardiology, research, physiotherapy, nursing, epidemiology and register backgrounds (7 responses). Ratings, comments and suggestions were collated and discussed by the NCRM Taskforce, and the indicators rated most important, useful and feasible were retained, resulting in 10 QIs. These 10 QIs were presented at the ACRA national conference and then discussed at a workshop (55 participants) for this purpose. Ten QIs and accompanying data dictionary with definitions, evidence and allowable values is the final product. Conclusions A minimum set of locally relevant, internationally recognised, national QIs for CR is now available for CR providers, health service managers and researchers in Australia, which may be relevant internationally. The QIs will best serve national interests incorporated within a national cardiac registry but will also be useful for site audits and have strong potential to be aggregated across sites, health districts and states. The definitive test of the QIs will be how useful they are for CR program coordinators and funders of such programs; a key consideration for building sustainable business models and ensuring long-term implementation. Funding Acknowledgement Type of funding source: None


Endoscopy ◽  
2021 ◽  
Author(s):  
Geir Hoff ◽  
Edoardo Botteri ◽  
Gert Huppertz-Hauss ◽  
Jan Magnus Kvamme ◽  
Øyvind Holme ◽  
...  

Abstract Background Systematic training in colonoscopy is highly recommended; however, we have limited knowledge of the effects of “training-the-colonoscopy-trainer” (TCT) courses. Using a national quality register on colonoscopy performance, we aimed to evaluate the effects of TCT participation on defined quality indicators. Methods This observational study compared quality indicators (pain, cecal intubation, and polyp detection) between centers participating versus not participating in a TCT course. Nonparticipating centers were assigned a pseudoparticipating year to match their participating counterparts. Results were compared between first year after and the year before TCT (pseudo)participation. Time trends up to 5 years after TCT (pseudo)participation were also compared. Generalized estimating equation models, adjusted for age, sex, and bowel cleansing, were used. Results 11 participating and 11 nonparticipating centers contributed 18 555 and 10 730 colonoscopies, respectively. In participating centers, there was a significant increase in detection of polyps ≥ 5 mm, from 26.4 % to 29.2 % (P = 0.035), and reduction in moderate/severe pain experienced by women, from 38.2 % to 33.6 % (P = 0.043); no significant changes were found in nonparticipating centers. Over 5 years, 20 participating and 18 nonparticipating centers contributed 85 691 and 41 569 colonoscopies, respectively. In participating centers, polyp detection rate increased linearly (P = 0.003), and pain decreased linearly in women (P = 0.004). Nonparticipating centers did not show any significant time trend during the study period. Conclusions Participation in a TCT course improved polyp detection rates and reduced pain experienced by women. These effects were maintained during a 5-year follow-up.


2019 ◽  
Vol 60 (11) ◽  
pp. 1054
Author(s):  
Jun Ki Min ◽  
Jae Myung Cha ◽  
Min Seob Kwak ◽  
Jin Young Yoon ◽  
Yunho Jung ◽  
...  

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 101-101
Author(s):  
Sarah D Tait ◽  
Yi Ren ◽  
Cushanta C. Horton ◽  
Sachiko M. Oshima ◽  
Samantha M. Thomas ◽  
...  

101 Background: Overall breast cancer mortality in the US has declined since 1990, but racial/ethnic disparities have worsened. Since 1992, NC BCCCP has provided free/low-cost breast cancer screening to underserved women as part of a national effort by the Centers for Disease Control and Prevention (CDC) to mitigate these disparities. We sought to characterize and evaluate benchmarks for this previously unstudied, state-level cohort. Methods: We identified women ≥18y who underwent their first breast cancer screening via NC BCCCP from 2009-2018. Univariate analysis was used to compare differences in timeline of care and rates of breast pathology (i.e., cancer or atypia) by race/ethnicity and age. Logistic and negative binomial regression were used to identify factors associated with cancer diagnosis and time from enrollment to diagnosis (TTD) and treatment (TTT), respectively. Results: 88,893 women with complete records were identified (median age 50y, IQR 44-56): 45.5% were Non-Hispanic (NH) white, 30.9% NH black, 19.5% Hispanic, 1.7% American Indian (AI), and 1.1% Asian. Overall participation peaked in 2012 but steadily increased among Hispanic women over time (p < 0.001). Breast pathology was diagnosed in 2,016 (2.3%) women, with rates ranging from 1% in Hispanic women to 2.7% in NH whites. After adjustment, Hispanic women were least likely (vs NH white women: OR 0.40; 95% CI 0.34-0.47) to be diagnosed with breast cancer. Median TTD was 19d and TTT was 33d, both within the CDC’s 60d standard. In univariate analyses, women < 50 had shorter TTD (median 18d vs 21d) and TTT (median 30d vs 35d) vs women ≥50 (both p < 0.01), and there were no significant differences by race/ethnicity or between women with atypia vs cancer. In multivariate models, however, older age and NH black race were associated with longer TTD and TTT. Conclusions: NC BCCCP meets national quality benchmarks for TTD and TTT. These data also highlight broader opportunities to achieve racial/ethnic parity and improve equity for breast cancer prevention. [Table: see text]


2012 ◽  
Vol 22 (2) ◽  
pp. 155-162 ◽  
Author(s):  
Melanie Couralet ◽  
Henri Leleu ◽  
Frederic Capuano ◽  
Leah Marcotte ◽  
Gérard Nitenberg ◽  
...  

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