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Healthcare Providers Play Role In Likelihood Of Colorectal Cancer Screening
A new study published in Cancer reports that the
likelihood
of patients' obtaining colorectal cancer screenings is dependent on
health care providers. Dr. Melissa M. Farmer of Veterans Affairs and
colleagues suggest that interventions targeting both the provider and
the
patient are needed to boost colorectal cancer screening
rates. Specifically, patient barriers such as concerns about payment and
worries that cancer will be discovered must be taken into account.
Despite colorectal cancer being the third leading cause of cancer
death in both US men and women, national screening rates remain
relatively low. However, there has been growing
recognition of the importance of screening in reducing cancer mortality.
Dr. Farmer and colleagues were chiefly interested in the potential
barriers to colorectal cancer screening. The researchers analyzed data
from a study conducted at
UCLA's Jonsson Comprehensive Cancer Center and the UCLA School of
Public
Health. They examined trends and predictors of colorectal cancer
screening from telephone surveys done prior to and
after a quality improvement intervention for screening. Survey
participants were all members of a large
managed care health plan, allowing the researchers to assess barriers
to screening in an environment where access to care was not one of them.
Two surveys were conducted. The first contained 498 individuals
aged 50 years and older surveyed in 2000. The second consisted of 482
different individuals in the same age group surveyed in 2003. The
researchers used specific guidelines to assess whether individuals
received colorectal cancer screening - a fecal occult blood
test
every year, sigmoidoscopy every 5 years, or colonoscopy every 10 years.
A fecal occult blood test is a check for hidden blood in the stool, a
sigmoidoscopy is a minimally invasive medical examination of the large
intestine from the rectum through the last part of the colon, and a
colonoscopy is an examination of the large colon and the distal part of
the small bowel with a camera.
Key findings include:
Colorectal cancer screening rates increased over the
three-year period, though there was evidence of underutilization
38% of patients in 2000 reported that they had been
screened with any test
50% of patients in 2003 reported that they had been
screened with any test
Patients who reported discussing colorectal cancer
screening with doctors were significantly more likely to have a
screening.
Participants who were concerned about cost or who were
afraid of a cancer diagnosis were less likely to be screened.
The results "suggest that interventions focused solely on educating
patients are not likely to increase rates significantly," according to
the authors. "The provider and related health care system must be able
to include discussions and recommendations for colorectal cancer
screening in practice." They conclude by calling for multilevel
interventions that target both the provider and patient in order to
increase screening rates.
Predictors of Colorectal Cancer Screening From Patients
Enrolled in a Managed Care Health Plan.
Melissa M. Farmer, Roshan Bastani, Lorna Kwan, Michael Belman, and
Patricia A. Ganz
CANCER; Published Online: February 11, 2008
DOI: 10.1002/cncr.23290
Print Issue Date: March 15, 2008.
Click
Here to View Abstract
Written by: Peter M Crosta
Copyright: Start Sanatate
Not to be reproduced without permission of Start Sanatate
Furnizorii serviciilor de asistenþã medicalã joace rolul în riscul de cancer colorectal de screening - Healthcare Providers Play Role In Likelihood Of Colorectal Cancer Screening - articole medicale engleza - startsanatate