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Santiago-Rodríguez EJ, Shariff-Marco S, Bailey ZD, White JS, Allen IE, Hiatt RA. Residential Segregation and Colorectal Cancer Screening in the United States, 2010 to 2018. Cancer Epidemiol Biomarkers Prev 2025; 34:705-713. [PMID: 39969522 PMCID: PMC12048236 DOI: 10.1158/1055-9965.epi-24-1424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2024] [Revised: 12/03/2024] [Accepted: 02/13/2025] [Indexed: 02/20/2025] Open
Abstract
BACKGROUND Residential segregation limits the access to resources, primarily because of disinvestment. This study evaluated the association between residential segregation and colorectal cancer screening in the United States and whether findings differed by race and ethnicity. METHODS Restricted National Health Interview Survey data (2010-2018) were used to ascertain colorectal cancer screening adherence per US Preventive Services Task Force recommendations. Residential segregation was operationalized using the Index of Concentration at the Extremes (ICE), based on income, race, and ethnicity information obtained from the 2014 to 2018 American Community Survey estimates for counties. Multivariable logistic regression models with robust variance estimators accounting for within-county correlation were used. Analyses were stratified by race and ethnicity and weighted to represent the US population. RESULTS In this cross-sectional study (n = 44,690), participants residing in less advantaged counties had lower colorectal cancer screening adherence than those residing in the most advantaged counties [Q1 vs. Q5, OR (95% confidence interval): ICE income, 0.77 (0.70-0.86); ICE race, 0.86 (0.77-0.96); ICE race + income, 0.75 (0.67-0.84)]. In analyses stratified by race and ethnicity, we observed that overall findings were mostly driven by White people and estimates were less precise with no clear gradients among racial and ethnic minoritized groups. Among Black participants, colorectal cancer screening did not vary across quintiles of economic segregation. CONCLUSIONS Residential segregation was associated with colorectal cancer screening. IMPACT Interventions aimed at improving colorectal cancer screening uptake in the United States should address structural barriers present in areas with higher concentrations of low-income minoritized racial and ethnic groups and how features of residential segregation might differentially affect racial and ethnic groups.
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Affiliation(s)
- Eduardo J. Santiago-Rodríguez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, USA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Greater Bay Area Cancer Registry, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - Zinzi D. Bailey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Justin S. White
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Isabel E. Allen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Robert A. Hiatt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
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Pignone M, Chang P, Kluz N, Altillo B, Fekete A, Martinez A, Medbery R, Queralt Y, Shah K, Vanin L. Achieving Equitable Lung Cancer Screening Implementation in a Texas Safety Net Health System. Am J Prev Med 2025; 68:227-235. [PMID: 39343325 DOI: 10.1016/j.amepre.2024.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 09/20/2024] [Accepted: 09/22/2024] [Indexed: 10/01/2024]
Abstract
INTRODUCTION A lung cancer screening program using low dose CT (LDCT) in a Federally Qualified Health Center (FQHC) in Central Texas was developed and assessed for equitable implementation. METHODS From 11/2020-8/2023, patients aged 55-77 years who currently smoked or quit within 15 years with ≥20 pack-years of exposure were identified through EHR query and mailed outreach, or through direct provider referrals. A bilingual social worker confirmed eligibility, provided telecare shared decision-making (SDM), coordinated screening, and offered smoking cessation. To assess equity, LDCT completion across demographics was compared, in 2023. RESULTS A total of 6,486 patients were mailed outreach materials; 479 patients responded, of whom 108 (22.5%) were eligible and 71 (65.7%) participated in SDM. 629 eligible patients were referred internally; 579 (92.0%) completed SDM. Of the 650 patients who completed SDM, 636 (97.8%) agreed to screening. Mean age was 61.7 years; 38.1% were female. The population was diverse: 35.8% identified as Latino, 17.8% as African American, 26.8% had Medicare or Medicaid, 48.0% used the county medical assistance program, 14.2% were uninsured, and 76.7% currently smoked. Overall, 528 (83.0%) patients completed LDCT. There were no statistically significant differences in completion by age, gender, race/ethnicity, or insurance status. Spanish-speaking patients were more likely to complete the CT than English speakers (OR 2.22, 95% CI=1.22, 4.41) and those who formerly smoked were more likely to complete the CT than patients who currently smoked (OR 1.93, 95% CI=1.12, 3.51). CONCLUSIONS The navigator-centered program achieved equitable implementation of lung cancer screening in a diverse FQHC system.
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Affiliation(s)
- Michael Pignone
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina; Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Patrick Chang
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Nicole Kluz
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas.
| | - Brandon Altillo
- Department of Population Health, Dell Medical School, The University of Texas at Austin, Austin, Texas; Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas; CommUnityCare Health Centers, Austin, Texas
| | - Andrea Fekete
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas; Central Health East Multispecialty Clinic, Austin, Texas
| | - Amaris Martinez
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas
| | - Rachel Medbery
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas; Cardiothoracic and Vascular Surgeons, Austin, Texas
| | - Yvonne Queralt
- Department of Diagnostic Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas; Austin Radiological Association, Austin, Texas
| | - Koonj Shah
- Department of Internal Medicine, Dell Medical School, The University of Texas at Austin, Austin, Texas; Dell Seton Medical Center, Ascension, Austin, Texas
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Issaka RB, Bell-Brown A, Jewell T, Jackson SL, Weiner BJ. Interventions to Increase Follow-Up of Abnormal Stool-Based Colorectal Cancer Screening Tests in Safety Net Settings: A Systematic Review. Gastroenterology 2024; 167:826-833.e3. [PMID: 39306373 DOI: 10.1053/j.gastro.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2024]
Affiliation(s)
- Rachel B Issaka
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington; Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, Washington; Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington.
| | - Ari Bell-Brown
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Teresa Jewell
- Health Science Library, University of Washington, Seattle, Washington
| | - Sara L Jackson
- Department of Medicine, University of Washington, Seattle, Washington
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, Washington; Department of Health Systems and Population Health, University of Washington, Seattle, Washington
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Issaka RB, Bell-Brown A, Jewell T, Jackson SL, Weiner BJ. Interventions to Increase Follow-Up of Abnormal Stool-Based Colorectal Cancer Screening Tests in Safety Net Settings: A Systematic Review. Clin Gastroenterol Hepatol 2024; 22:1967-1974.e3. [PMID: 39322372 DOI: 10.1016/j.cgh.2024.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/02/2024] [Indexed: 09/27/2024]
Affiliation(s)
- Rachel B Issaka
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington; Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, Washington; Division of Gastroenterology, University of Washington School of Medicine, Seattle, Washington.
| | - Ari Bell-Brown
- Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Teresa Jewell
- Health Science Library, University of Washington, Seattle, Washington
| | - Sara L Jackson
- Department of Medicine, University of Washington, Seattle, Washington
| | - Bryan J Weiner
- Department of Global Health, University of Washington, Seattle, Washington; Department of Health Systems and Population Health, University of Washington, Seattle, Washington
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May FP, Brodney S, Tuan JJ, Syngal S, Chan AT, Glenn B, Johnson G, Chang Y, Drew DA, Moy B, Rodriguez NJ, Warner ET, Anyane-Yeboa A, Ukaegbu C, Davis AQ, Schoolcraft K, Regan S, Yoguez N, Kuney S, Le Beaux K, Jeffries C, Lee ET, Bhat R, Haas JS. Community Collaboration to Advance Racial/Ethnic Equity in Colorectal Cancer Screening: Protocol for a Multilevel Intervention to Improve Screening and Follow-up in Community Health Centers. Contemp Clin Trials 2024; 145:107639. [PMID: 39068985 DOI: 10.1016/j.cct.2024.107639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
INTRODUCTION Colorectal cancer (CRC) screening utilization is low among low-income, uninsured, and minority populations that receive care in community health centers (CHCs). There is a need for evidence-based interventions to increase screening and follow-up care in these settings. METHODS A multilevel, multi-component pragmatic cluster randomized controlled trial is being conducted at 8 CHCs in two metropolitan areas (Boston and Los Angeles), with two arms: (1) Mailed FIT outreach with text reminders, and (2) Mailed FIT-DNA with patient support. We also include an additional CHC in Rapid City (South Dakota) that follows a parallel protocol for FIT-DNA but is not randomized due to lack of a comparison group. Eligible individuals in participating clinics are primary care patients ages 45-75, at average-risk for CRC, and overdue for CRC screening. Participants with abnormal screening results are offered navigation for follow-up colonoscopy and CRC risk assessment. RESULTS The primary outcome is the completion rate of CRC screening at 90 days. Secondary outcomes include the screening completion rate at 180 days and the rate of colonoscopy completion within 6 months among participants with an abnormal result. Additional goals are to enhance our understanding of facilitators and barriers to CRC risk assessment in CHC settings. CONCLUSIONS This study assesses the effectiveness of two multilevel interventions to increase screening participation and follow-up after abnormal screening in under-resourced clinical settings, informing future efforts to address CRC disparities. TRIAL REGISTRATION NCT05714644.
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Affiliation(s)
- Folasade P May
- Department of Medicine, David Geffen School of Medicine, UCLA Ronald Reagan Medical Center, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095, USA; Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 650 S. Charles E Young Drive, Center for Health Sciences, Suite A2-125, Los Angeles, CA 90095-6900, USA; Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, USA; UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, 650 S. Charles E Young Drive, Center for Health Sciences, Suite A2-125, Los Angeles, CA 90095-6900, USA
| | - Suzanne Brodney
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jessica J Tuan
- UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, 650 S. Charles E Young Drive, Center for Health Sciences, Suite A2-125, Los Angeles, CA 90095-6900, USA
| | - Sapna Syngal
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, MA, USA; Population Sciences and Cancer Genetics and Prevention Divisions, Dana Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Beth Glenn
- UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, 650 S. Charles E Young Drive, Center for Health Sciences, Suite A2-125, Los Angeles, CA 90095-6900, USA; Department of Health Policy and Management, UCLA Fielding School of Public Health, United States of America; UCLA Center for Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, UCLA School of Public Health, Los Angeles, CA 90095-6900, USA
| | - Gina Johnson
- Community Health Prevention Programs, Great Plains Tribal Leaders Health Board, Rapid City, SD, USA
| | - Yuchiao Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - David A Drew
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Beverly Moy
- Division of Hematology/Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicolette J Rodriguez
- Division of Gastroenterology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Erica T Warner
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Adjoa Anyane-Yeboa
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Chinedu Ukaegbu
- Population Sciences and Cancer Genetics and Prevention Divisions, Dana Farber Cancer Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Anjelica Q Davis
- Fight Colorectal Cancer, 134 Park Central Sq. Ste 210, Springfield, MO 65806, USA
| | - Kimberly Schoolcraft
- Fight Colorectal Cancer, 134 Park Central Sq. Ste 210, Springfield, MO 65806, USA
| | - Susan Regan
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Nathan Yoguez
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | - Samantha Kuney
- Population Sciences and Cancer Genetics and Prevention Divisions, Dana Farber Cancer Institute, Boston, MA, USA
| | - Kelley Le Beaux
- Community Health Prevention Programs, Great Plains Tribal Leaders Health Board, Rapid City, SD, USA
| | - Catherine Jeffries
- Community Health Prevention Programs, Great Plains Tribal Leaders Health Board, Rapid City, SD, USA
| | - Ellen T Lee
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roopa Bhat
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer S Haas
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA; Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Zhao MY, Lei YY, Aaronson MRM, De Silva SR, Badiee J, May FP. Colorectal Cancer Screening Rates at Federally Qualified Health Centers From 2014 to 2022: Incomplete Recovery From COVID-19 and Worsening Disparities. Am J Gastroenterol 2024; 119:1580-1589. [PMID: 38529856 DOI: 10.14309/ajg.0000000000002706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/15/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION Federally Qualified Health Centers (FQHC) provide preventive health services such as colorectal cancer (CRC) screening to low-income and underinsured individuals. Overall CRC screening participation in the United States declined during the COVID-19 pandemic and recovered by 2021; however, trends in underresourced settings are unknown. METHODS Using Uniform Data System data from 2014 to 2022, we assessed trends in FQHC CRC screening rates nationally, in California, and in Los Angeles County and determined clinic-level factors associated with recent screening rate changes. For each FQHC, we calculated the screening rate change from 2019 to 2020, 2020 to 2021, and 2020 to 2022. We used mixed-effects linear regression to determine clinic-level characteristics associated with each screening rate change. RESULTS Across all FQHC (n = 1,281), 7,016,181 patients were eligible for CRC screening in 2022. Across the United States and in California, median screening rates increased from 2014 to 2019, severely declined in 2020, and failed to return to prepandemic levels by 2022. Both nationally and in California, CRC screening declined most dramatically from 2019 to 2020 in FQHC serving majority Hispanic/Latino patients or a high proportion of patients experiencing homelessness. From 2020 to 2022, screening rates did not recover completely in US FQHC, with disproportionate recovery among FQHC serving majority non-Hispanic Black patients. DISCUSSION CRC screening rates at FQHC did not return to prepandemic levels by 2022, and recovery varied by FQHC patient characteristics. Tailored interventions addressing low and decreasing CRC screening rates in FQHC are urgently needed to mitigate worsening CRC disparities.
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Affiliation(s)
- Matthew Y Zhao
- David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Yvonne Y Lei
- David Geffen School of Medicine, UCLA, Los Angeles, California, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Megan R M Aaronson
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Sadie R De Silva
- David Geffen School of Medicine, UCLA, Los Angeles, California, USA
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Jayraan Badiee
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
| | - Folasade P May
- Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
- Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
- UCLA Kaiser Permanente Center for Health Equity, Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California, USA
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7
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Olmstead T, Spencer JC, Kluz N, Zhan FB, Shokar NK, Pignone M. Costs and Projected Effect of a Federally Qualified Health Center-Based Mailed Colorectal Cancer Screening Program in Texas. Prev Chronic Dis 2024; 21:E30. [PMID: 38696253 PMCID: PMC11086695 DOI: 10.5888/pcd21.230266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2024] Open
Abstract
Introduction Mailed stool testing for colorectal cancer (CRC) may improve screening uptake and reduce the incidence and mortality of CRC, especially among patients at federally qualified health centers (FQHCs). To expand screening programs it is important to identify cost-effective approaches. Methods We developed a decision-analytic model to estimate the cost, effects on screening and patient outcomes (CRCs detected, CRCs prevented, CRC deaths prevented), and cost-effectiveness of implementing a state-wide mailed stool testing program over 5 years among unscreened, age-eligible (aged 50-75 y) patients at FQHCs in Texas. We compared various outreach strategies and organizational structures (centralized, regional, or a hybrid). We used data from our existing regional mailed stool testing program and recent systematic reviews to set parameters for the model. Costs included start-up and ongoing activities and were estimated in 2022 US dollars from the perspective of a hypothetical third-party payer. Cost-effectiveness was assessed by using both incremental and average cost-effectiveness ratios. Results Using either a statewide centralized or hybrid organizational configuration to mail stool tests to newly eligible FQHC patients and patients who have responded at least once since program inception is likely to result in the best use of resources over 5 years, enabling more than 110,000 additional screens, detecting an incremental 181 to 194 CRCs, preventing 91 to 98 CRCs, and averting 46 to 50 CRC deaths, at a cost of $10 million to $11 million compared with no program. Conclusions A statewide mailed stool testing program for FQHC patients can be implemented at reasonable cost with considerable effects on CRC screening outcomes, especially when its structure maximizes program efficiency while maintaining effectiveness.
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Affiliation(s)
- Todd Olmstead
- Lyndon B Johnson School of Public Affairs, The University of Texas at Austin
- University of Texas at Austin, Lyndon B Johnson School of Public Affairs, 2315 Red River Street, Austin TX 78712
| | - Jennifer C Spencer
- Department of Population Health, The University of Texas at Austin Dell Medical School
- Department of Internal Medicine, The University of Texas at Austin Dell Medical School
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School
| | - Nicole Kluz
- Department of Internal Medicine, The University of Texas at Austin Dell Medical School
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School
| | - F Benjamin Zhan
- Department of Population Health, The University of Texas at Austin Dell Medical School
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School
- Texas Center for Geographic Information Science, Department of Geography and Environmental Studies, Texas State University, San Marcos, Texas
| | - Navkiran K Shokar
- Department of Population Health, The University of Texas at Austin Dell Medical School
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School
| | - Michael Pignone
- Department of Population Health, The University of Texas at Austin Dell Medical School
- Department of Internal Medicine, The University of Texas at Austin Dell Medical School
- Livestrong Cancer Institutes, The University of Texas at Austin Dell Medical School
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Robertson DJ, Rex DK, Ciani O, Drummond MF. Colonoscopy vs the Fecal Immunochemical Test: Which is Best? Gastroenterology 2024; 166:758-771. [PMID: 38342196 DOI: 10.1053/j.gastro.2023.12.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 02/13/2024]
Abstract
Although there is no debate around the effectiveness of colorectal cancer screening in reducing disease burden, there remains a question regarding the most effective and cost-effective screening modality. Current United States guidelines present a panel of options that include the 2 most commonly used modalities, colonoscopy and stool testing with the fecal immunochemical test (FIT). Large-scale comparative effectiveness trials comparing colonoscopy and FIT for colorectal cancer outcomes are underway, but results are not yet available. This review will separately state the "best case" for FIT and colonoscopy as the screening tool of first choice. In addition, the review will examine these modalities from a health economics perspective to provide the reader further context about the relative advantages of these commonly used tests.
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Affiliation(s)
- Douglas J Robertson
- VA Medical Center, White River Junction, Vermont; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
| | - Douglas K Rex
- Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Oriana Ciani
- Centre for Research on Health and Social Care Management, SDA Bocconi School of Management, Milan, Italy
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Deleemans J, MacLeod J, Fuentes E, Glenn L, Glosik E, Leyh J, Ryan S, Sarcich M, Pole L. Exploring the Roles of Patient Advocates in Integrative Oncology. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:134-138. [PMID: 36763611 DOI: 10.1089/jicm.2023.0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- Julie Deleemans
- University of Calgary Cumming School of Medicine, Society for Integrative OncologyAYA CAN Canadian Support Community, Calgary, Alberta, Canada. ®, AYA CAN Canadian Support Community, Calgary, Alberta, Canada
| | - Jodi MacLeod
- Society for Integrative Oncology, Memorial Sloan Kettering Cancer Center, National Coalition of Cancer Survivorship, Breinigsville, PA, USA
| | - Eileen Fuentes
- Memorial Sloan Kettering Cancer Center, Society for Integrative Oncology, SWOG, New York, NY, USA
| | - Lesley Glenn
- Project Life, Society for Integrative Oncology, Metastatic Breast Cancer Alliance, National Coalition of Cancer Survivorship, Central Point, OR, USA
| | - Elizabeth Glosik
- Society for Integrative Oncology, Escape to Thrive, National Coalition of Cancer Survivorship, Brecksville, OH, USA
| | - Jenny Leyh
- Samueli Foundation's Integrative Health Programs, Society for Integrative Oncology, Integrative Oncology Leadership Collaborative, Haddon Heights, NJ, USA
| | - Susan Ryan
- Society for Integrative Oncology, Living Beyond Breast Cancer, Unite for Her, Collegeville, PA, USA
| | - Marianne Sarcich
- Society for Integrative Oncology, National Coalition of Cancer Survivorship, Wilmington, DE, USA
| | - Laura Pole
- Smith Center for Healing and the Arts, CancerChoices, Society for Integrative Oncology, Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative, Washington, DC, USA
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