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Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems.


ABSTRACT: BACKGROUND:To reduce colorectal cancer mortality, positive fecal blood tests must be followed by colonoscopy. METHODS:We identified 62,384 individuals ages 50 to 89 years with a positive fecal blood test between January 1, 2011 and December 31, 2012 in four health care systems within the Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We estimated the probability of follow-up colonoscopy and 95% confidence intervals (CI) using the Kaplan-Meier method. Overall differences in cumulative incidence of follow-up across health care systems were assessed with the log-rank test. HRs and 95% CIs were estimated from multivariate Cox proportional hazards models. RESULTS:Most patients who received a colonoscopy did so within 6 months of their positive fecal blood test, although follow-up rates varied across health care systems (P <0.001). Median days to colonoscopy ranged from 41 (95% CI, 40-41) to 174 (95% CI, 123-343); percent followed-up by 12 months ranged from 58.1% (95% CI, 51.6%-63.7%) to 83.8% (95% CI, 83.4%-84.3%) and differences across health care systems were also observed at 1, 2, 3, and 6 months. Increasing age and comorbidity score were associated with lower follow-up rates. CONCLUSION:Individual characteristics and health care system were associated with colonoscopy after positive fecal blood tests. Patterns were consistent across health care systems, but proportions of patients receiving follow-up varied. These findings suggest that there is room to improve follow-up of positive colorectal cancer screening tests. IMPACT:Understanding the timing of colonoscopy after positive fecal blood tests and characteristics associated with lack of follow-up may inform future efforts to improve follow-up.

SUBMITTER: Chubak J 

PROVIDER: S-EPMC4767632 | biostudies-literature | 2016 Feb

REPOSITORIES: biostudies-literature

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Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems.

Chubak Jessica J   Garcia Michael P MP   Burnett-Hartman Andrea N AN   Zheng Yingye Y   Corley Douglas A DA   Halm Ethan A EA   Singal Amit G AG   Klabunde Carrie N CN   Doubeni Chyke A CA   Kamineni Aruna A   Levin Theodore R TR   Schottinger Joanne E JE   Green Beverly B BB   Quinn Virginia P VP   Rutter Carolyn M CM  

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20160201 2


<h4>Background</h4>To reduce colorectal cancer mortality, positive fecal blood tests must be followed by colonoscopy.<h4>Methods</h4>We identified 62,384 individuals ages 50 to 89 years with a positive fecal blood test between January 1, 2011 and December 31, 2012 in four health care systems within the Population-Based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium. We estimated the probability of follow-up colonoscopy and 95% confidence intervals (CI) using the  ...[more]

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