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Cancer. 2018 Apr 1;124 Suppl 7:1568-1575. doi: 10.1002/cncr.31287.

A physician-initiated intervention to increase colorectal cancer screening in Chinese patients.

Author information

1
Chinese Community Health Resource Center, San Francisco, California.
2
Department of Psychiatry, University of California at San Francisco, San Francisco, California.
3
Department of Internal Medicine, University of California at Davis, Sacramento, California.
4
Jade Health Care Medical Group, San Francisco, California.
5
Department of Public Health Sciences, University of California at Davis, Davis, California.
6
Division of General Internal Medicine, University of California at San Francisco, San Francisco, California.

Abstract

BACKGROUND:

Among Chinese American individuals, only approximately 42% of cases of colorectal cancer (CRC) are diagnosed at an early stage, possibly because these patients are less likely than non-Hispanic white individuals to undergo CRC screening.

METHODS:

Primary care physicians (PCPs) were recruited from a local independent practice association serving Chinese Americans and randomized into early-intervention and delayed-intervention groups. PCPs in the early-intervention group received continuing medical education (CME), and their patients received an intervention mailer, consisting of a letter with the PCP's recommendation, a bilingual educational booklet, and a fecal occult blood test (FOBT) kit in year 1. PCPs in the delayed-intervention group received no CME, and their patients received the mailers in year 2.

RESULTS:

A total of 20 PCPs were assigned to the early-intervention and 22 PCPs to the delayed-intervention group. A total of 3120 patients of these participating PCPs who had undergone CRC screening that was due during the study period were included. A total of 915 mailers were sent in year 1 and 830 mailers were sent in year 2. FOBT screening rates increased from 26.7% at baseline to 58.5% in year 1 in the early-intervention group versus 19.6% at baseline to 22.2% in year 1 in the delayed-intervention group (P<.0001). The overall effect size of the mailer intervention with or without CME was estimated as a difference of 26.6 percentage points (95% confidence interval, 22.0-31.2 percentage points) from baseline compared with usual care. The intervention was found to have no impact on rates of colonoscopy or sigmoidoscopy.

CONCLUSIONS:

The results of the current pilot study demonstrated that a mailer including educational materials and FOBT kits can increase CRC screening rates with or without CME for the PCPs. Cancer 2018;124:1568-75. © 2018 American Cancer Society.

KEYWORDS:

Chinese; colorectal cancer screening; fecal occult blood test (FOBT)/fecal immunochemical test (FIT); physician network; provider initiated

PMID:
29578594
PMCID:
PMC5873593
[Available on 2019-04-01]
DOI:
10.1002/cncr.31287

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