Disparities in Colorectal Cancer Screening Practices in a Midwest Urban Safety-Net Healthcare System.
Aged
Aging
Colorectal Neoplasms
/ diagnosis
Cross-Sectional Studies
Delivery of Health Care
Early Detection of Cancer
/ methods
Feces
Female
Humans
Insurance, Health
Male
Mass Screening
Medicaid
Middle Aged
Midwestern United States
/ epidemiology
Occult Blood
Odds Ratio
Retrospective Studies
Risk Factors
United States
Colorectal neoplasm
Early detection of cancer
Fecal immunochemical test
Preventive medicine
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
22
01
2020
accepted:
06
08
2020
pubmed:
21
8
2020
medline:
23
9
2021
entrez:
21
8
2020
Statut:
ppublish
Résumé
Although colorectal cancer screening (CRC) using stool-based test is well-studied, evidence on fecal immunochemical test (FIT) patterns in a safety-net healthcare system utilizing opportunistic screening is limited. We studied the FIT completion rates and adenoma detection rate (ADR) of positive FIT-colonoscopy (FIT-C) in an urban safety-net system. We performed a retrospective cross-sectional chart review on individuals ≥ 50 years who underwent CRC screening using FIT or screening colonoscopy, 09/01/2017-08/30/2018. Demographic differences in FIT completion were studied; ADR of FIT-C was compared to that of screening colonoscopy. Among 13,427 individuals with FIT ordered, 7248 (54%) completed the stool test and 230 (48%) followed up a positive FIT with colonoscopy. Increasing age (OR 1.01, CI 1.01-1.02), non-Hispanic Blacks (OR 0.87, CI 0.80-0.95, p = 0.002), current smokers (OR 0.84, CI 0.77-0.92, p < 0.0001), those with Medicaid (OR 0.86, CI 0.77-0.96, p = 0.006), commercial insurance (OR 0.85, CI 0.78-0.94, p = 0.002), CCI score ≥ 3 (OR 0.82, CI 0.74-0.91, p < 0.0001), orders by family medicine providers (OR 0.87, CI 0.81-0.94, p < 0.0001) were associated with lower completion of stool test. Individuals from low median household income cities had lower follow-up of positive FIT, OR 0.43, CI 0.21-0.86, p = 0.017. ADR of FIT-C was higher than that of screening colonoscopy. Adherence to CRC screening is low in safety-net systems employing opportunistic screening. Understanding demographic differences may allow providers to formulate targeted strategies in high-risk vulnerable groups.
Identifiants
pubmed: 32816217
doi: 10.1007/s10620-020-06545-3
pii: 10.1007/s10620-020-06545-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2585-2594Informations de copyright
© 2020. Springer Science+Business Media, LLC, part of Springer Nature.
Références
Siegel RL, Miller KD, Ahmedin JD. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34.
doi: 10.3322/caac.21551
Gellad ZF, Provenzale D. Colorectal cancer: national and international perspective on the burden of disease and public health impact. Gastroenterology. 2010;138:2177–2190.
doi: 10.1053/j.gastro.2010.01.056
US Preventive Services Task Force, Bibbins-Domingo K, Grossman DC, et al. Screening for colorectal cancer: US preventive services task force recommendation statement. JAMA. 2016;315:2564–2575.
Mandel JS, Church TR, Bond JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med. 2000;343:1603–1607.
doi: 10.1056/NEJM200011303432203
Shaukat A, Mongin SJ, Geisser MS, et al. Long-term mortality after screening for colorectal cancer. N Engl J Med. 2013;369:1106–1114.
doi: 10.1056/NEJMoa1300720
Cole SR, Young GP, Esterman A, Cadd B, Morcom J. A randomised trial of the impact of new faecal haemoglobin test technologies on population participation in screening for colorectal cancer. J Med Screen. 2003;10:117–122.
doi: 10.1177/096914130301000304
van Rossum LG, van Rijn AF, Laheij RJ, et al. Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology. 2008;135:82–90.
doi: 10.1053/j.gastro.2008.03.040
Quintero E, Castells A, Bujanda L, et al. Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. N Engl J Med. 2012;366:697–706.
doi: 10.1056/NEJMoa1108895
Robertson DJ, Lee JK, Boland CR, et al. Recommendations on fecal immunochemical testing to screen for colorectal neoplasia: a consensus statement by the US multi-society task force on colorectal cancer. Gastroenterology. 2017;152:1217–1237.e3.
doi: 10.1053/j.gastro.2016.08.053
Young GP, Cole SR. Which fecal occult blood test is best to screen for colorectal cancer? Nat Clin Pract Gastroenterol Hepatol. 2009;6:140–141.
doi: 10.1038/ncpgasthep1358
Ladabaum U, Mannalithara A. Comparative effectiveness and cost effectiveness of a multitarget stool DNA test to screen for colorectal neoplasia. Gastroenterology. 2016;151:427–439.e6.
doi: 10.1053/j.gastro.2016.06.003
United States Census Bureau. QuickFacts Ohio. Available from: https://www.census.gov/quickfacts/fact/table/OH/INC110217 . Accessed August 8, 2019.
Hol L, Wilschut J, van Ballegooijen M, et al. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels. Br J Cancer. 2009;100:1103–1110.
doi: 10.1038/sj.bjc.6604961
Martin J, Halm E, Tiro J, et al. Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system. Am J Med. 2017;130:93.
doi: 10.1016/j.amjmed.2016.12.033
Chubak J, Garcia MP, Burnett-Hartman AN, et al. Time to colonoscopy after positive fecal blood test in four U.S. health care systems. Cancer Epidemiol Biomarkers Prev a Publ Am Assoc Cancer Res Cosponsored by Am Soc Prev Oncol. 2016;25:344–350.
doi: 10.1158/1055-9965.EPI-15-0470
Fisher DA, Jeffreys A, Coffman CJ, Fasanella K. Barriers to full colon evaluation for a positive fecal occult blood test. Cancer Epidemiol Biomarkers Prev. 2006;15:1232–1235.
doi: 10.1158/1055-9965.EPI-05-0916
Garman KS, Jeffreys A, Coffman C, Fisher DA. Colorectal cancer screening, comorbidity, and follow-up in elderly patients. Am J Med Sci. 2006;332:159–163.
doi: 10.1097/00000441-200610000-00001
Carlson CM, Kirby KA, Casadei MA, Partin MR, Kistler CE, Walter LC. Lack of follow-up after fecal occult blood testing in older adults: Inappropriate screening or failure to follow up? Arch Intern Med. 2011;171:249–256.
doi: 10.1001/archinternmed.2010.372
Bakhai S, Ahluwalia G, Nallapeta N, Mangat A, Reynolds JL. Faecal immunochemical testing implementation to increase colorectal cancer screening in primary care. BMJ Open Qual. 2018;7:e000400.
doi: 10.1136/bmjoq-2018-000400
Burnett-Hartman AN, Mehta SJ, Zheng Y, et al. Racial/ethnic disparities in colorectal cancer screening across healthcare systems. Am J Prev Med. 2016;51:e107–e115.
doi: 10.1016/j.amepre.2016.02.025
Oluloro A, Petrik AF, Turner A, et al. Timeliness of colonoscopy after abnormal fecal test results in a safety net practice. J Commun Health. 2016;41:864–870.
doi: 10.1007/s10900-016-0165-y
Thamarasseril S, Bhuket T, Chan C, Liu B, Wong RJ. The need for an integrated patient navigation pathway to improve access to colonoscopy after positive fecal immunochemical testing: a safety-net hospital experience. J Commun Health. 2017;42:551–557.
doi: 10.1007/s10900-016-0287-2
Hall I, Tangka F, Sabatino S, Thompson T, Graubard B, Breen N. Patterns and trends in cancer screening in the United States. Prev Chronic Dis. 2018;15:170465.
doi: 10.5888/pcd15.170465
Inadomi JM, Vijan S, Janz NK, et al. Adherence to colorectal cancer screening: a randomized clinical trial of competing strategies. Arch Intern Med. 2012;172:575–582.
doi: 10.1001/archinternmed.2012.332
Thomsen MK, Rasmussen M, Njor SH, Mikkelsen EM. Demographic and comorbidity predictors of adherence to diagnostic colonoscopy in the Danish Colorectal Cancer Screening Program: a nationwide cross-sectional study. Clin Epidemiol. 2018;10:1733–1742.
doi: 10.2147/CLEP.S176923
Whitley EM, Raich PC, Dudley DJ, et al. Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer. 2017;123:312–318.
doi: 10.1002/cncr.30316
Carlos RC, Underwood W 3rd, Fendrick AM, Bernstein SJ. Behavioral associations between prostate and colon cancer screening. J Am Coll Surg. 2005;200:216–223.
doi: 10.1016/j.jamcollsurg.2004.10.015
Sanford NN, Sher DJ, Butler S, et al. Cancer screening patterns among current, former, and never smokers in the United States, 2010–2015. JAMA Netw Open. 2020;2:e193759.
doi: 10.1001/jamanetworkopen.2019.3759
Quaife SL, McEwen A, Janes SM, Wardle J. Smoking is associated with pessimistic and avoidant beliefs about cancer: results from the International Cancer Benchmarking Partnership. Br J Cancer. 2015;112:1799–1804.
doi: 10.1038/bjc.2015.148
Kim EY, Shim YS, Kim YS, Lee SP, Ko KD, Choi WJ. Adherence to general medical checkup and cancer screening guidelines according to self-reported smoking status: Korea National Health and Nutrition Examination Survey (KNHANES) 2010–2012. PLoS One. 2019;14:e0224224.
doi: 10.1371/journal.pone.0224224
Seibert RG, Hanchate AD, Berz JP, Schroy PC 3rd. National disparities in colorectal cancer screening among obese adults. Am J Prev Med. 2017;53:e41–e49.
doi: 10.1016/j.amepre.2017.01.006
Zapka JM, Klabunde CN, Arora NK, Yuan G, Smith JL, Kobrin SC. Physicians’ colorectal cancer screening discussion and recommendation patterns. Cancer Epidemiol Biomarkers Prev a Publ Am Assoc Cancer Res Cosponsored by Am Soc Prev Oncol. 2011;20:509–521.
doi: 10.1158/1055-9965.EPI-10-0749
Higgins AY, Doubeni ARB, Phillips KL, et al. Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine versus internal medicine practices in the United States: a cross-sectional study. BMC Gastroenterol. 2012;12:23.
doi: 10.1186/1471-230X-12-23
National Colorectal Cancer Roundtable. About 80% by 2018. Available from: http://nccrt.org/wp-content/uploads/80by2018TalkingPoints.pdf . Accessed August 11, 2019.
White A, Vernon SW, Franzini L, Du XL. Racial and ethnic disparities in colorectal cancer screening persisted despite expansion of Medicare’s screening reimbursement. Cancer Epidemiol Biomarkers Prev. 2011;20:811–817.
doi: 10.1158/1055-9965.EPI-09-0963
Joseph DA, King JB, Richards TB, Thomas CC, Richardson LC. Use of colorectal cancer screening tests by state. Prev Chronic Dis. 2018;15:E80.
doi: 10.5888/pcd15.170535
Singal AG, Gupta S, Skinner CS, et al. Effect of colonoscopy outreach versus fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial. JAMA. 2017;318:806–815.
doi: 10.1001/jama.2017.11389
Selby K, Baumgartner C, Levin TR, et al. Interventions to improve follow-up of positive results on fecal blood tests: a systematic review. Ann Int Med. 2017;167:565–575. https://doi.org/10.7326/M17-1361 .
doi: 10.7326/M17-1361
pubmed: 29049756
Issaka RB, Avila P, Whitaker E, Bent S, Somsouk M. Population health interventions to improve colorectal cancer screening by fecal immunochemical tests: a systematic review. Prev Med (Baltim). 2019;118:113–121.
doi: 10.1016/j.ypmed.2018.10.021
Levin TR, Corley DA, Jensen CD, et al. Effects of organized colorectal cancer screening on cancer incidence and mortality in a large community-based population. Gastroenterology. 2018;155:1383–1391.e5.
doi: 10.1053/j.gastro.2018.07.017