Economic Models of Colorectal Cancer Screening in Average-Risk Adults Workshop Summary (2005) / Chapter Skim
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Appendix L Current Evidence on Compliance --Sally W. Vernon, M.A., Ph.D.
Appendix L Current Evidence on Compliance --Sally W. Vernon, M.A., Ph.D.
Pages 208-219
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Appendix L Current Evidence on Compliance Sally W Vernon, M.A., Ph.D.
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The 3rd question requires some extrapolation from existing data because it hasn't been studied directly. I will share some thoughts about how we might arrive at a best guess, but I think this question warrants discussion.
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There are 2 national data sources that have collected self-report data on use of CRC screening tests the National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS)
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And the BFRSS may ask more refined questions about such patterns in future surveys. SLIDE 4 SLIDE NOTES 4: Data from the other national survey, the BRFSS, cover the time period 1997 to 2002.
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The prevalence and the rate of increase are higher than for recent FOBT. As with FOBT, adults with less than a high school education were less likely to report SIG or colonoscopy than all adults.
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Another factor that has not been looked at in national surveys but that is strongly associated with adherence to cancer screening recommendations, including CRC screening, is having a physician recommend the test. Data from the National Cancer Institute's Health Information and Trends Survey (HINTS)
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Of all cancer screening tests for which we have data, Pap testing prevalence is the highest. Rates have been steady at ~85% since 1992.
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The question I would pose from the data viewed collectively is: What makes Pap testing different from the other tests, particularly DRE and PSA? They all are relatively inexpensive, require contact with a physician, can be done easily in the context of a primary care visit, and they aren't very different in terms of their invasiveness.
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. Roughly 60 to 70 percent of physicians say that they are recommending or performing colon cancer screening tests on their average-risk patients.
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A study by Myers and colleagues (Myers et al., 2001) compared measurement of complete diagnostic evaluation after a positive FOBT by 4 methods external chart review, internal chart audit, administrative data review, and a combination of chart review and administrative data notes and found that rates ranged from 49 to 79%.
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2003. A national survey of primary care physicians' colorectal cancer screening recommendations and practices.
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2003. Progress in cancer screening practices in the United States: Results from the 2000 National Health Interview Survey.
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