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July 16, 2018
The sending of colorectal cancer screening tests to Medicaid-insured patients increased screening rates for this population, report researchers at the Comprehensive Cancer Center of the University of North Carolina. In Charlotte, researchers at the Carolina Cancer Screening Initiative of UNC Lineberger have examined the impact of targeted outreach to more than 2,100 people insured by Medicaid who donâ € ™ t have. were not up-to-date in colorectal cancer screening. The project resulted in a nearly 9 percentage point increase in screening rates for patients who received a mail-out package compared to patients who had just been recalled and demonstrated that their method could be used as a screening tool. model to improve screening. ladder. The results were published in the journal Cancer .
The American Cancer Society estimates that more than 97,000 people will be diagnosed with colorectal cancer in the United States this year, resulting in about 50,600 deaths. It is the third most common type of cancer in the United States and the second leading cause of cancer death.
Although colorectal cancer screening has been shown to be effective in reducing cancer deaths, researchers report that not enough people are screened. The current ACS guidelines recommend regular screening with a high sensitivity stool test or structural (visual) examination for average risk individuals aged 45 and over, and that all positive results should be monitored with colonoscopy. Despite these recommendations, studies have identified significant gaps in screening rates, including by race, geographic region, and other socioeconomic factors. Among insured patients, people with Medicaid have the lowest rates of colorectal cancer screening.
"There has been a national push to increase colorectal cancer screening rates since colorectal cancer is a preventable disease, but screening rates," said Alison Brenner, Ph.D., MPH, Assistant Professor in research at the Department of Internal Medicine of the UNC School of Medicine, 19659003] For the project, the researchers sent reminders about colorectal cancer screening and instructions on how to get started. organize with the health service or reminders plus a fecal immunochemical test, or FIT kit, which can detect blood in the stool – a symptom of colon cancer.The patient completes the test at home and sends it back to a provider for Patients who have a positive FIT kit result will be scheduled for colonoscopy.
UNC Lineberger researchers worked with staff from the County of Mecklenburg Health Department, who coordinated the ra ppels and shipments.They also partnered with Medicaid Care Coordinators to provide navigational support to patients with abnormal findings and requiring colonoscopy.
Twenty-one percent of patients who received FIT kits responded to the screening test, compared with 12% of patients who received a recall. Eighteen people who completed the FIT tests had abnormal results, and 15 of these people were eligible for colonoscopy. Of the 10 who completed the colonoscopy, one patient had an abnormal result.
"Preventive care among vulnerable populations seldom reaches the top of the mental queue of things that need to be done," Brenner said. "In North Carolina, many Medicaid beneficiaries have disabilities, so it's very important to make colorectal cancer screening as simple and transparent as possible, even if the hurdles are simple." Brenner said The study shows the potential of exploiting resources like the county health department for health prevention services
"This effort to improve pragmatic and collaborative quality demonstrates the feasibility , the acceptability and effectiveness of existing health services. Stephanie Wheeler, Ph.D., MPH, Associate Professor at UNC Gillings School of Global Public Health and lead author of the study.
She said the researchers plan to go ahead to study if they can implement their approach on a large scale
"It's about 39 expand the medical district – exploit community resources to target patients and, in this case, insured patients, who may not receive primary health care. the organization of care, and how to increase screening rates in these types of vulnerable populations, "Brenner said.
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