Improving colon cancer screening rates in primary care: a pilot study emphasising the role of the medical assistant (original) (raw)

Colorectal cancer disparities beyond biology Screening treatment access

Frontiers in Bioscience, 2017

Introduction 2.1. Colorectal cancer incidence and mortality in the U.S. 2.2. Variations by race 3. Is biology to blame? 4. The role of screening 4.1. Colorectal cancer screening recommendations and methods 4.2. Uptake of and engagement in screening 4.3. Interventions designed to decrease barriers and promote screening 5. The health care system and colorectal cancer racial disparities 5.1. Treatment differences between African American and white patients 5.2. Variations in quality of and access to care by race 6. African Americans and colorectal cancer: Where do we go from here? 7. References Society estimates that, in 2016, 134,490 new cases of CRC will be diagnosed (1). The lifetime risk of developing CRC is approximately 1 in 21 for men and 1 in 23 for women (1). CRC is the second leading cause of cancerrelated deaths in the United States among cancers that affect both men and women (2). In 2016, 49,190 deaths are estimated to occur as a result of CRC (1). Both CRC incidence and mortality rates increase with age. The overwhelming majority of new cases and deaths (90% and 93%, respectively) occur in individuals aged 50 and above (3). CRC diagnosis is most frequent among individuals aged 65-74 with a median age at diagnosis of 68 years old, while CRC mortality is highest among those aged 75-84 with a mean age of 73 years old (4). Rates of CRC vary at the population level with respect to different individual-level characteristics. One of the most distinctive biological differences noted is that CRC incidence and mortality rates among men are estimated to be 30%-40% higher than those of women (5). Some researchers posit that this significant difference may be attributable to complex interactions between gender-related differences when exposed to hormones and various risk factors (6). Another significant variation in CRC incidence and mortality is that observed between races. 2.2. Variations by race CRC incidence in the United States increased steadily from 1975 through the 1980s, but has since been Colorectal cancer disparities beyond biology 466

Colorectal Cancer Screening Attitudes and Practices in the General Population

Journal of Public Health Management and Practice, 2005

L. Pashos r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r Objectives: To characterize self-reported colorectal cancer (CRC) screening behavior, and to identify characteristics of CRC screening practices, stratified by risk. Methods: Using random-digit-dial methodology, we conducted telephone surveys in US adults 50 years of age and older. Respondents provided data on utilization of CRC screening tests; demographic characteristics; and awareness, concerns, attitudes and beliefs about the tests, CRC, and health care. On the basis of available guidelines, three definitions of adequate screening were considered. Results: Among persons reporting having ever had a CRC screening exam, the exam was more likely to have been a fecal occult blood test than a radiologic or endoscopic exam (p < .0001). Subjects at increased CRC risk were more likely to have met the screening criteria (p < .001) compared with average-risk subjects. Receipt of information or advice about cancer screening tests, male gender, and concern about managed care were positively associated with adequate screening. Smoking, low health self-monitoring, and an average risk for CRC reduced the probability of CRC screening. Conclusions: Lack of awareness about screening remains common, regardless of CRC risk. Providing information and advice about cancer screening may be the single most important tool available to improve screening rates.

Developing a Clinical Practice Guideline for Colorectal Cancer Screening in Primary Care

2021

Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States for both men and women combined. CRC screening is an effective way to reduce mortality and morbidity related to the disease. Practitioners within primary care practices can play an essential role in encouraging people to be screened. Yet, CRC screening rates remain low in primary care practices. Evidence-based strategies are available to help practitioners improve CRC screening activities and improve screening rates. The lack of a clinical practice guideline (CPG) with strategies to help improve CRC screening interventions was identified as a practice gap for this project. The practice-focused question for this project aimed to address this gap: In a primary care practice, in which CRC screening rates are low amongst adults 50 to 75 years of age, evidence-based best practices contributed to a CPG for CRC screening in the primary care setting. The practice-, provider-, and patient-level (P3) mod...

Colorectal cancer, screening and primary care: A mini literature review

Colorectal cancer (CRC) is a common health problem, representing the third most commonly diagnosed cancer worldwide and causing a significant burden in terms of morbidity and mortality, with annual deaths estimated at 700000. The western way of life, that is being rapidly adopted in many regions of the world, is a well discussed risk factor for CRC and could be targeted in terms of primary prevention. Furthermore, the relatively slow development of this cancer permits drastic reduction of incidence and mortality through secondary prevention. These facts underlie primary care physicians (PCPs) being assigned a key role in health strategies that enhance prevention and prompt diagnosis. Herein, we review the main topics of CRC in the current literature, in order to better understand its pathogenesis, risk and protective factors, as well as screening techniques. Furthermore, we discuss preventive and screening policies to combat CRC and the crucial role served by PCPs in their successful implementation. Relevant articles were identified through electronic searches of MEDLINE and through manual searches of reference lists.