Details:

Alternative Title:
Cancer
Personal Author:
Bharti, Balambal ; Popoola May, Folasade (Fola) ; Nodora, Jesse ; Elena Martinez, Maria ; Moyano, Karina ; ... More +
Bharti, Balambal ; Popoola May, Folasade (Fola) ; Nodora, Jesse ; Elena Martinez, Maria ; Moyano, Karina ; Davis, Shauntay L. ; Boyd Ramers, Christian ; Garcia-Bigley, Felipe ; O’Connell, Shawne ; Ronan, Kevin ; Barajas, Melissa ; Gordon, Sheree ; Diaz, Giselle ; Ceja, Evelyn ; Powers, Meghan ; Arredondo, Elva M. ; Gupta, Samir Less -
Description:
Background:

Effectiveness of colorectal cancer (CRC) screening with fecal immunochemical stool blood tests (FIT) requires high rates of colonoscopy follow up for abnormal FIT, and use of high quality tests. We characterized colonoscopy referral and completion among patients with abnormal FIT, and type of FIT implemented in a sample of Southern California Federally Qualified Health Centers (FQHCs).

Methods:

FQHCs in San Diego, Imperial, and Los Angeles counties were invited to define a cohort of ≥150 consecutive abnormal FIT patients 2015–2016 and provide data on gender, insurance status, diagnostic colonoscopy referral and completion within six months of abnormal FIT, and type (brand) of FIT implemented. Primary outcomes were proportion with colonoscopy referral and completion for all patients at each FQHC and in aggregate.

Results:

Eight FQHCs provided data for 1,229 patients with abnormal FIT; 46% were male and 20% uninsured. Among abnormal FIT patients, 89% (n=1,091/1,229; 95%CI: 0.87–0.91) had colonoscopy referral and 44% (n=539/1,229; 95%CI: 0.41–0.47) had colonoscopy completion. Across FQHCs, range for colonoscopy referral was 73–96% and completion was 18–57%. Six of eight (75%) FQHCs reported FIT brands with limited data to support effectiveness.

Conclusions:

In a sample of Southern California FQHCs, diagnostic colonoscopy completion after abnormal FIT was substantially below the nationally recommended benchmark to achieve 80% completion, and use of FIT brands with limited data to support effectiveness was high. These findings suggest a need for policies and multi-level interventions to promote diagnostic colonoscopy among individuals with abnormal FIT, and use of higher quality FITs.


Subjects:
[+]
Adult Article Colonoscopy Colorectal Neoplasms Cross-Sectional Studies Early Detection Of Cancer Feces Female Humans Immunochemistry Male Middle Aged Treatment Outcome Young Adult
Source:
Cancer. 125(23):4203-4209
Pubmed ID:
31479529
Pubmed Central ID:
PMC7008958
Document Type:
Journal Article
Funding:
U54 CA132384/CA/NCI NIH HHS/United States ; U54CA132384/National Institute of Health (NIH)/International ; CA023100-32/Specialized Cancer Center Support Grant to the UC San Diego Moores Cancer Center/International ; U58 DP003862/DP/NCCDPHP CDC HHS/United States ; U54CA132379/National Institute of Health (NIH)/International ; ... More +
U54 CA132384/CA/NCI NIH HHS/United States ; U54CA132384/National Institute of Health (NIH)/International ; CA023100-32/Specialized Cancer Center Support Grant to the UC San Diego Moores Cancer Center/International ; U58 DP003862/DP/NCCDPHP CDC HHS/United States ; U54CA132379/National Institute of Health (NIH)/International ; U54CA143931/Charles Drew University-University of California Los Angeles/International ; CC/CDC HHS/United States ; CA023100-32/University of California San Diego Moores Cancer Center/International ; U54CA143931/Charles Drew Univeristy (CDU)-UCLA Partnership to Eliminate Cancer Disparities Grant/International ; U54CA132384/National Institute of Health/International ; U54CA132379/National Institute of Health/International ; P30 CA023100/CA/NCI NIH HHS/United States ; U54 CA132379/CA/NCI NIH HHS/United States ; U54 CA143931/CA/NCI NIH HHS/United States Less -
Place as Subject:
California
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a9de70117c82430649760b67fba05c281a7b65a59fad81dd0237802ba6e5d9e8
Download URL:
https://stacks.cdc.gov/view/cdc/85016/cdc_85016_DS1.pdf
File Type:

Supporting Files

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  	NIHMS1042805-supplement-AppendixB.docx	docx
  	NIHMS1042805-supplement-supp_AppendixA.pdf	pdf

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