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Implementation Science
Published in: Implementation Science 1/2015

Open Access 01-12-2015 | Research

Mailed participant reminders are associated with improved colonoscopy uptake after a positive FOBT result in Ontario’s ColonCancerCheck program

Authors: David Stock, Linda Rabeneck, Nancy N Baxter, Lawrence F Paszat, Rinku Sutradhar, Lingsong Yun, Jill Tinmouth

Published in: Implementation Science | Issue 1/2015

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Abstract

Background

Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. This study evaluates the effectiveness of two ongoing interventions designed to improve colonoscopy uptake after a positive fecal occult blood test (FOBT) result within Ontario’s population-wide ColonCancerCheck program. The first was a revision of mailed FOBT lab results to physicians to explicitly define a positive FOBT and to recommend colonoscopy. The second was a letter to participants informing them of the positive FOBT and urging them to seek appropriate follow-up.

Methods

Prospective cohort study using Ontario’s ColonCancerCheck program data sets (2008–2011), linked to provincial administrative health databases. Crude rate ratios were calculated to assess determinants of colonoscopy uptake among an Ontario-wide FOBT-positive cohort with rolling enrolment, followed from October 2008 through February 2011. Segmented time-series regression was used to assess the average additional change in colonoscopy uptake after FOBT-positive status following the introduction of two ongoing interventions among the same cohort.

Results

A notification mailed directly to FOBT-positive screening participants was observed to increase colonoscopy uptake, beyond the modest average underlying increase throughout the study period, by an average of 3% per month (multivariable-adjusted RR: 1.03, 95% CI: 1.00–1.06). However, revision of the existing FOBT result notification to physicians was observed to have no effect.

Conclusions

Direct participant notification of a positive FOBT result improved adherence with follow-up colonoscopy in Ontario’s population-wide ColonCancerCheck program. Further participant-directed interventions may be effective means of maximizing adherence in population-wide screening.
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Literature
1.
Canadian Cancer Society’s Advisory Committee on Cancer Statistics: Canadian Cancer Statistics 2013. Canadian Cancer Society 2013.
2.
Heresbach D, Manfredi S, D’Halluin PN, Bretagne JF, Branger B. Review in depth and meta-analysis of controlled trials on colorectal cancer screening by faecal occult blood test. Eur J Gastroenterol Hepatol. 2006;18:427–33.CrossRefPubMed
3.
Hewitson P, Glasziou P, Irwig L, Towler B, Watson E. Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database Syst Rev. 2007;1.
4.
Rabeneck L, Tinmouth JM, Paszat LF, Baxter NN, Marrett LD, Ruco A, et al. Ontario’s ColonCancerCheck: results from Canada’s first province-wide colorectal cancer screening program. Cancer Epidemiol Biomarkers Prev. 2014;23:508–15.CrossRefPubMed
5.
Statistics Canada. Estimates of population, by age group and sex for July 1, Canada, provinces and territories, annual (CANSIM Table 051-0001). Ottawa: Statistics Canada; 2010 [accessed June 24 2014].
6.
Logan RF, Patnick J, Nickerson C, Coleman L, Rutter MD, von Wagner C. Outcomes of the bowel cancer screening programme (BCSP) in England after the first 1 million tests. Gut. 2012;61:1439–46.CrossRefPubMed
7.
Leuraud K, Jezewski-Serra D, Saline E. Evaluation épidémiologique du programme de dépistage organisé du cancer colorectal en France: Première évaluation depuis la généralisation du programme pour 46 départements sur la période 2008–2009. Saint-Maurice. Institut de veille sanitaire; 2012. 29 p.
8.
Paterson WG, Depew WT, Pare P, Petrunia D, Switzer C, van Zanten SJV, et al. Canadian consensus on medically acceptable wait times for digestive health care. Can J Gastroenterol. 2006;20:411–23.CrossRefPubMedPubMedCentral
9.
Correia AJ, Rabeneck L, Paszat LF, Baxter NN, Sutradhar R, Tinmouth J. Factors associated with lack of follow-up following a positive FOBT. Gastroenterology. 2011;140:S–51.
10.
Robles SC, Marrett LD, Clarke EA, Risch HA. An application of capture-recapture methods to the estimation of completeness of cancer registration. J Clin Epidemiol. 1988;41:495–501.CrossRefPubMed
11.
Bressler B, Paszat LF, Chen Z, Rothwell DM, Vinden C, Rabeneck L. Rates of new or missed colorectal cancers after colonoscopy and their risk factors: a population-based analysis. Gastroenterology. 2007;132:96–102.CrossRefPubMed
12.
Austin PC, van Walraven C, Wodchis WP, Newman A, Anderson GM. Using the Johns Hopkins Aggregated Diagnosis Groups (ADGs) to predict mortality in a general adult population cohort in Ontario, Canada. Med Care. 2011;49:932–9.CrossRefPubMedPubMedCentral
13.
Jee SH, Cabana MD. Indices for continuity of care: a systematic review of the literature. Med Care Res Rev MCRR. 2006;63:158–88.CrossRefPubMed
14.
Jaakkimainen L, Klein-Geltink JE, Guttmann A, Barnsley J, Zagorski BM, Kopp A, et al. Indicators of primary care based on administrative data. In: Primary Care in Ontario: ICES Atlas. Toronto: Institute for Clinical Evaluative Sciences; 2006.
15.
Gillings D, Makuc D, Siegel E. Analysis of interrupted time series mortality trends: an example to evaluate regionalized perinatal care. Am J Public Health. 1981;71:38–46.CrossRefPubMedPubMedCentral
16.
17.
Myers RE, Turner B, Weinberg D, Hyslop T, Hauck WW, Brigham T, et al. Impact of a physician-oriented intervention on follow-up in colorectal cancer screening. Prev Med. 2004;38:375–81.CrossRefPubMed
18.
Humphrey LL, Shannon J, Partin MR, O’Malley J, Chen Z, Helfand M. Improving the follow-up of positive hemoccult screening tests: an electronic intervention. J Gen Intern Med. 2011;26:691–7.CrossRefPubMedPubMedCentral
19.
Larson MF, Ko CW, Dominitz JA. Effectiveness of a provider reminder on fecal occult blood test follow-up. Dig Dis Sci. 2009;54:1991–6.CrossRefPubMed
20.
Singh H, Kadiyala H, Bhagwath G, Shethia A, El-Serag H, Walder A, et al. Using a multifaceted approach to improve the follow-up of positive fecal occult blood test results. Am J Gastroenterol. 2009;104:942–52.CrossRefPubMedPubMedCentral
21.
Van Kleek E, Liu S, Conn LM, Hoadley A, Ho SB. Improving the effectiveness of fecal occult blood testing in a primary care clinic by direct colonoscopy referral for positive tests. J Healthc Qual. 2010;32:62–9.CrossRefPubMed
22.
Miglioretti DL, Rutter CM, Bradford SC, Zauber AG, Kessler LG, Feuer EJ, et al. Improvement in the diagnostic evaluation of a positive fecal occult blood test in an integrated health care organization. Med Care. 2008;46:S91–6.CrossRefPubMedPubMedCentral
23.
Cha JM, Lee JI, Joo KR, Shin HP, Park JJ. Telephone reminder call in addition to mailing notification improved the acceptance rate of colonoscopy in patients with a positive fecal immunochemical test. Dig Dis Sci. 2011;56:3137–42.CrossRefPubMed
24.
Zorzi M, Giorgi Rossi P, Cogo C, Falcini F, Giorgi D, Grazzini G, et al. A comparison of different strategies used to invite subjects with a positive faecal occult blood test to a colonoscopy assessment. A randomised controlled trial in population-based screening programmes. Prev Med. 2014;65C:70–6.CrossRef
25.
Health Quality Ontario. Electronic tools for health information exchange: an evidence-based analysis. Ont Health Technol Assess Ser. 2013;13:1–76.
26.
Swan H, Siddiqui AA, Myers RE. International colorectal screening programs: population contact strategies, testing methods and screening rates. Pract Gastroenterol. 2012;36:8.
Metadata
Title
Mailed participant reminders are associated with improved colonoscopy uptake after a positive FOBT result in Ontario’s ColonCancerCheck program
Authors
David Stock
Linda Rabeneck
Nancy N Baxter
Lawrence F Paszat
Rinku Sutradhar
Lingsong Yun
Jill Tinmouth
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2015
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-015-0226-0

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