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Improving Colorectal Cancer Screening Rates in Patients Referred to a Gastroenterology Clinic

Bick, Benjamin L.; El-Halabi, Mustapha; Jones, Keaton R.; Kahi, Charles J.; Fayad, Nabil F.

The Journal for Healthcare Quality (JHQ): July/August 2019 - Volume 41 - Issue 4 - p 243–250
doi: 10.1097/JHQ.0000000000000170
Original Article

ABSTRACT Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in the United States. Colonoscopy and fecal immunochemistry testing (FIT) are the primary recommended CRC screening modalities. The purpose of this study is to improve rates of CRC screening in Veterans and County hospital patients referred to gastroenterology fellow's clinics. A total of 717 patients between ages of 49 and 75 years were seen. Previous CRC screening was not performed in 109 patients (15.2%) because of not being offered (73.4%) or declining (26.6%) screening. Patients who received previous CRC screening compared with no previous screening were older (mean age 62.3 years vs. 60.3 years, p < .003), white (88.6% vs. 78.3%, p < .027), and more likely to be Veterans patients (90.8% vs. 77.5%, p < .001). After systematically discussing options for screening with 78 of the 109 unscreened patients, 56 of them (71.8%) underwent screening with either colonoscopy (32) or FIT (24). Patients seen by fellows in their last year of training agreed to undergo screening more often than those seen by other fellows (100% vs. 66.2%, p < .033). Systematic discussions about both colonoscopy and FIT can improve the overall rates of CRC screening.

For more information on this article, contact Nabil F. Fayad at

The authors declare no conflicts of interest.

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© 2019 National Association for Healthcare Quality
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