Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan

Hillyer, Grace Clarke; Basch, Charles E.; Schmitt, Karen M.; Neugut, Alfred I.

doi:10.1016/j.ypmed.2011.06.011

Cited by 10 publications

(25 citation statements)

References 43 publications

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“…These results are in contrast to previous observational research that has shown that acculturation to the US is positively related with the use of preventive and cancer screening services [7, 15–19, 24–26]. However, studies conducted in the context of a patient navigation programs have shown that acculturation to the US is negatively correlated with CRCS [14, 27]. In other words, it is likely that less acculturated individuals, who prefer Spanish and more recently immigrated, are more likely to adhere to colonoscopy guidelines than more acculturated individuals if they receive a recommendation for screening and patient navigation services.…”

Section: Discussioncontrasting

confidence: 95%

Examining the Impact of Latino Nativity, Migration, and Acculturation Factors on Colonoscopy Screening

et al. 2016

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Objective Latinos are a diverse population comprised of multiple countries of origin with varying cultural profiles. This study examines differences in colonoscopy completion across place of birth and migration-related factors in a sample of predominantly Dominican and Puerto Rican Latinos living in New York City after receiving a recommendation for colonoscopy screening and navigation services. Design The sample included 702 Latinos recruited for two cancer screening projects targeting Latinos eligible for colonoscopy who seek healthcare in New York City. Participants completed a survey that included sociodemographic, health-related questions, psychosocial assessments and cancer screening practices, in Spanish or English. Results Migration, acculturation, and language factors were found to predict colonoscopy completion. The results indicated that Latinos born in the Dominican Republic and Central America were more likely to complete a screening colonoscopy than their counterparts born in the US. Further, those who emigrated at an older age, who have resided in the US for less than 20 years, preferred Spanish and those with lower US acculturation levels were also more likely to complete a screening colonoscopy. Conclusion The findings suggest that Latinos who are less acculturated to the US are more likely to complete a screening colonoscopy after receiving a physician recommendation for colonoscopy screening. The results provide important information that can inform clinical practice and public health interventions. Continued attention to cultural and migration influences are important areas for cancer screening intervention development.

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Section: Discussioncontrasting

confidence: 95%

Examining the Impact of Latino Nativity, Migration, and Acculturation Factors on Colonoscopy Screening

et al. 2016

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“…For example, if rural patients are more burdened with competing demands, structural barriers to accessing care (e.g., transportation), and costs of care, then systems may need to prioritize FOBT/FIT with colonoscopy follow-up on abnormal tests. Launching FOBT/FIT kit campaigns may be particularly impactful in addressing screening disparities in rural and Medicaid populations as they help reduce structural and geographic barriers to CRC screening and have demonstrated effectiveness and cost-effectiveness in these populations (Briant et al, 2015; Charlton et al, 2014; Hillyer et al, 2011; Coronado et al, 2011; Gupta et al, 2013b). …”

Section: Discussionmentioning

confidence: 99%

Geographic and population-level disparities in colorectal cancer testing: A multilevel analysis of Medicaid and commercial claims data

Davis

Renfro

Pham

et al. 2017

Preventive Medicine

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Morbidity and mortality from colorectal cancer (CRC) can be attenuated through guideline concordant screening and intervention. This study used Medicaid and commercial claims data to examine individual and geographic factors associated with CRC testing rates in one state (Oregon). A total of 64,711 beneficiaries (4516 Medicaid; 60,195 Commercial) became newly age-eligible for CRC screening and met inclusion criteria (e.g., continuously enrolled, no prior history) during the study period (January 2010–December 2013). We estimated multilevel models to examine predictors for CRC testing, including individual (e.g., gender, insurance, rurality, access to care, distance to endoscopy facility) and geographic factors at the county level (e.g., poverty, uninsurance). Despite insurance coverage, only two out of five (42%) beneficiaries had evidence of CRC testing during the four year study window. CRC testing varied from 22.4% to 46.8% across Oregon's 36 counties; counties with higher levels of socioeconomic deprivation had lower levels of testing. After controlling for age, beneficiaries had greater odds of receiving CRC testing if they were female (OR 1.04, 95% CI 1.01–1.08), commercially insured, or urban residents (OR 1.14, 95% CI 1.07–1.21). Accessing primary care (OR 2.47, 95% CI 2.37–2.57), but not distance to endoscopy (OR 0.98, 95% CI 0.92–1.03) was associated with testing. CRC testing in newly age-eligible Medicaid and commercial members remains markedly low. Disparities exist by gender, geographic residence, insurance coverage, and access to primary care. Work remains to increase CRC testing to acceptable levels, and to select and implement interventions targeting the counties and populations in greatest need.

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“…MailedFIT was the main intervention and had the most impact in increasing screening; FluFIT, MammoFIT, and 50th birthday mailings had a limited reach to smaller patient cohorts. The supplemental offering of FIT kits during flu shot clinics and mammography screening events resulted in more than one‐half of individuals returning the kits and could be a cost‐effective approach …”

Section: Discussionmentioning

confidence: 99%

“…The supplemental offering of FIT kits during flu shot clinics and mammography screening events resulted in more than one-half of individuals returning the kits and could be a cost-effective approach. 16,17 Overall, nearly one-third of patients who were due for screening successfully participated in the FIT program. Despite potential facilitators, such as receiving mailings in their preferred language and wordless instructions, most of those who received the FIT kits did not complete the screenings.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and cost of multilayered colorectal cancer screening promotion interventions at federally qualified health centers in Washington State

Kemper¹,

Glaze²,

Eastman

et al. 2018

Cancer

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BACKGROUND: It has been demonstrated that fecal immunochemical test (FIT) mailing programs are effective for increasing colorectal cancer (CRC) screening. The objectives of the current study were to assess the magnitude of uptake that could be achieved with a mailed FIT program in a federally qualified health center and whether such a program can be implemented at a reasonable cost to support sustainability. METHODS: The Washington State Department of Health’s partner HealthPoint implemented a direct-mail FIT program at 9 medical clinics, along with a follow-up reminder letter and automated telephone calls to those not up-to-date with recommended screening. Supplemental outreach events at selected medical clinics and a 50th birthday card screening reminder program also were implemented. The authors collected and analyzed process, effectiveness, and cost measures and conducted a systematic assessment of the short-term cost effectiveness of the interventions. RESULTS: Overall, 5178 FIT kits were mailed with 4009 follow-up reminder letters, and 8454 automated reminder telephone calls were made over 12 months. In total, 1607 FIT kits were returned within 3 months of the end of the implementation period: an overall return rate of 31% for the mailed FIT program. The average total intervention cost per FIT kit returned was $39.81, and the intervention implementation cost per kit returned was $18.76. CONCLUSIONS: The mailed FIT intervention improved CRC screening uptake among HealthPoint’s patient population. This intervention was implemented for less than $40 per individual successfully screened. The findings and lessons learned can assist other clinics that serve disadvantaged populations to increase their CRC screening adherence.

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Feasibility and efficacy of pairing fecal immunochemical testing with mammography for increasing colorectal cancer screening among uninsured Latinas in northern Manhattan

Abstract: This study suggests that pairing CRC education and screening with mammography is both feasible and efficacious.

Cited by 10 publications

References 43 publications

Examining the Impact of Latino Nativity, Migration, and Acculturation Factors on Colonoscopy Screening

Examining the Impact of Latino Nativity, Migration, and Acculturation Factors on Colonoscopy Screening

Geographic and population-level disparities in colorectal cancer testing: A multilevel analysis of Medicaid and commercial claims data

Effectiveness and cost of multilayered colorectal cancer screening promotion interventions at federally qualified health centers in Washington State

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