scholarly journals The attitudes of primary care providers towards screening for colorectal cancer

2013 ◽  
Vol 105 (5) ◽  
pp. 272-278 ◽  
Author(s):  
Jesús López-Torres Hidalgo ◽  
M.ª José Simarro-Herráez ◽  
Joseba Rabanales-Sotos ◽  
Ramona Campos-Rosa ◽  
Belén de la-Ossa-Sendra ◽  
...  
2012 ◽  
Vol 25 (5) ◽  
pp. 635-651 ◽  
Author(s):  
T. Salz ◽  
K. C. Oeffinger ◽  
P. R. Lewis ◽  
R. L. Williams ◽  
R. L. Rhyne ◽  
...  

Author(s):  
Jessica Law ◽  
Jeannine Viczko ◽  
Robert Hilsden ◽  
Emily McKenzie ◽  
Mark Watt ◽  
...  

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.


2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Jennifer M. Weiss ◽  
Perry J. Pickhardt ◽  
Jessica R. Schumacher ◽  
Aaron Potvien ◽  
David H. Kim ◽  
...  

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.


2011 ◽  
Vol 6 (3) ◽  
pp. 196-203 ◽  
Author(s):  
Joseph A. Diaz ◽  
Teresa Slomka

Although colorectal cancer is the third leading cause of cancer-related deaths in the United States, the burden of this disease could be dramatically reduced by increased utilization of screening. Evidence-based recommendations and guidelines from national societies recommend screening all average risk adults starting at age 50 years. However, the myriad screening options and slight differences in screening recommendations between guidelines may lead to confusion among patients and their primary care providers. In addition, varied colorectal cancer incidence and screening rates among different racial/ethnic groups, inconsistent screening recommendations based on family history and/or age, and increasing awareness of the role of nonadenomatous and nonpolypoid lesions also pose potential challenges to primary care providers when counseling patients. The goal of this review, therefore, is to briefly summarize the colorectal cancer screening guidelines issued by 3 major organizations, compare their recommendations, and address emerging issues in colorectal cancer screening.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E L Tolma ◽  
S M Aljunid ◽  
M N Amrizal ◽  
J Longenecker ◽  
A Al-Basmy ◽  
...  

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.


Inclusion ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 185-193
Author(s):  
Genevieve Breau ◽  
Sally Thorne ◽  
Jennifer Baumbusch ◽  
T. Greg Hislop ◽  
Arminee Kazanjian

Abstract Individuals with intellectual disability (ID) obtain breast, cervical, and colorectal cancer screening at lower rates, relative to the general population. This cross-sectional survey study explored how primary care providers and trainees recommend cancer screening to patients with ID, using a standardized attitudes questionnaire and vignettes of fictional patients. In total, 106 primary care providers and trainees participated. Analyses revealed that participants' attitudes towards community inclusion predicted whether participants anticipated recommending breast and colorectal cancer screening to fictional patients. Further research is needed to explore these factors in decisions to recommend screening, and how these factors contribute to cancer screening disparities.


2020 ◽  
Vol 9 (9) ◽  
pp. 3211-3223 ◽  
Author(s):  
Vincent L. Freeman ◽  
Keith B. Naylor ◽  
Emma E. Boylan ◽  
Benjamin J. Booth ◽  
Oksana Pugach ◽  
...  

2021 ◽  
Author(s):  
Diana R Withrow ◽  
Brian Shine ◽  
Jason Oke ◽  
Andres Tamm ◽  
Tim James ◽  
...  

Objective: Faecal immunochemical tests (FITs) are used to triage primary care patients with low risk colorectal cancer symptoms for referral to colonoscopy. The aim of this study was to determine whether combining FIT with routine blood test results could improve the performance of FIT in the primary care setting. Design: Results of all consecutive FITs requested by primary care providers between March 2017 and December 2020 were retrieved from the Oxford University Hospital Trust. Demographic factors (age, sex), reason for referral, and results of blood tests within 90 days were also retrieved. Patients were followed up for incident colorectal cancer in linked hospital records. The sensitivity, specificity, positive and negative predictive values of FIT alone, FIT paired with blood test results, and several multivariable FIT models, were compared. Results: Among 16,604 eligible patients, 139 colorectal cancers were diagnosed (0.8%). Sensitivity and specificity of FIT alone at a threshold of 10 μg Hb/g were 92.1% and 91.5% respectively. Compared to FIT alone, blood test results did not improve the performance of FIT. Pairing blood test abnormalities with FIT reduced the number of abnormal results needed to detect one cancer but increased the number of cancers missed. Multivariable models retaining FIT, sex, and mean cell volume performed similarly to FIT alone. Conclusion: FIT is a highly sensitive tool for identifying higher risk individuals presenting to primary care with lower risk symptoms. Combining blood test results with FIT does not appear to lead to better discrimination for colorectal cancer than using FIT alone.


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