A Randomized Controlled Trial to Increase Cancer Screening Among Attendees of Community Health Centers

Abstract

BACKGROUNDWe assessed the effi cacy of the Cancer Screening Offi ce Systems (Cancer SOS), an intervention designed to increase cancer screening in primary care settings serving disadvantaged populations.METHODS Eight primary care clinics participating in a county-funded health insurance plan in Hillsborough County, Fla, agreed to take part in a cluster-randomized experimental trial. The Cancer SOS had 2 components: a cancer-screening checklist with chart stickers that indicated whether specifi c cancer-screening tests were due, ordered, or completed; and a division of offi ce responsibilities to achieve high screening rates. Established patients were eligible if they were between the ages of 50 and 75 years and had no contraindication for screening. Data abstracted from charts of independent samples collected at baseline (n = 1,196) and at a 12-month follow-up (n = 1,237) was used to assess whether the patient was up-to-date on one or more of the following cancer-screening tests: mammogram, Papanicolaou (Pap) smear, or fecal occult blood testing (FOBT). RESULTSIn multivariate analysis that controlled for baseline screening rates, secular trends, and other patient and clinic characteristics, the intervention increased the odds of mammograms (odds ratio [OR] = 1.62, 95% confi dence interval [CI], 1.07-9.78, P = .023) and fecal occult blood tests (OR = 2.5, 95% CI, 1.65-4.0, P <.0001) with a trend toward greater use of Pap smears (OR = 1.57, 95% CI, 0.92-2.64, P = .096).

A Randomized Controlled Trial to Improve Colon Cancer Screening in Rural Family Medicine: An Iowa Research Network (IRENE) Study

“…Using the terms randomized trial and chart reminder and found 3 articles that assessed chart reminders to improve CRC screening. [33][34][35] In one of these studies, the use of office support systems, including chart reminders, increased the odds of completing mammography and FOBTs, 33 whereas in another study, use of a Comprehensive Annotated Reminder Tool did not increase FOBT but did increase many other services targeted by the tool. 34 Physician chart reminders did not improve CRC screening in another study of more than 20,000 patients.…”

The effects of teamwork and system support on colorectal cancer screening in primary care practices

“…Most studies that examine preventive CRC screening do so aiming to find the problem -e.g., patient barriers, [25][26][27][28][29][30] physician barriers, [5][6][7]31,32] system barriers [14,23,24,33,34] -and implement targeted interventions that solely impact CRC screening. These approaches, while successful to varying degrees, may be limited in their usefulness in applied practice settings for a number of reasons.…”

“…This grace period has been used in other studies. [23,24] For each eligible patient in the practice, a binary variable was created to indicate whether screening had occurred according to USPSTF/ACS recommendations (0 = no, 1 = yes).…”

Effectiveness of an Educational Intervention among Public Health Midwives on Breast Cancer Early Detection in the District of Gampaha, Sri Lanka

“…This type of colour code which was administered in Cancer Screening Office Systems (Cancer SOS), an intervention designed to increase cancer screening in primary care settings serving disadvantaged populations in Hills-borough County had been found to be effective (Roetzheim et al, 2004).…”