المؤلفون: Caroline E. Drolet, Kent Key, James Blessman, Todd Lucas, Hayley S. Thompson, Anurag Dawadi, Rhonda K. Dailey

المصدر: Psychology, Health & Medicine. 27:2073-2084

مصطلحات موضوعية: Crc screening, Colorectal cancer, Health Personnel, Theory of planned behavior, Receptivity, medicine.disease, 030227 psychiatry, Black or African American, 03 medical and health sciences, Psychiatry and Mental health, Clinical Psychology, 0302 clinical medicine, Colorectal cancer screening, medicine, Humans, 030212 general & internal medicine, Cultural Competency, Colorectal Neoplasms, Psychology, Psychosocial, Cultural competence, Healthcare providers, Early Detection of Cancer, Applied Psychology, Clinical psychology

الوصف: African Americans suffer disproportionately from colorectal cancer (CRC), due in part to disparities in CRC screening. Better understanding culturally relevant psychosocial factors that impact CRC screening is therefore critical. This study examined how African Americans' perceived cultural competency of their physician is associated with receptivity to take-home stool-based CRC screening. CRC screening deficient African Americans (N = 457) completed a patient-focused measure of perceived cultural competency and watched a brief video about CRC risks, prevention, and screening. Receptivity to stool-based CRC screening was measured using Theory of Planned Behavior (TPB) constructs . Participants were also given an opportunity to receive a no-cost at-home Fecal Immunochemical Test (FIT) kit, and we measured acceptance of this offer as a behavioral outcome (yes-no). Results showed that perceived cultural competency was associated with higher receptive attitudes, more favorable norms, greater perceived behavioral control towards stool-based screening, and also greater intentions to engage in FIT Kit screening (p < 0.001). We also found significant indirect effects of perceived cultural competency on FIT kit uptake through intention-mediated pathways. This study provides crucial evidence that participants' perceived cultural competency may play an important role in preventive health behavior among racial minorities, including CRC screening uptake among African Americans.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b43d9644e05069e5bb066f95ab0b2989Test
https://doi.org/10.1080/13548506.2021.1939073Test

المؤلفون: Anna Jervaeus, Yvonne Wengström, Kaisa Fritzell, Johanna Wangmar, Rolf Hultcrantz

المصدر: Patient Education and Counseling. 104:919-926

مصطلحات موضوعية: Value (ethics), Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Colorectal cancer, Decision Making, Psychological intervention, Overweight, 03 medical and health sciences, 0302 clinical medicine, Case fatality rate, medicine, Humans, Mass Screening, 030212 general & internal medicine, Early Detection of Cancer, Sweden, Crc screening, business.industry, 030503 health policy & services, Incidence (epidemiology), General Medicine, medicine.disease, digestive system diseases, Colorectal cancer screening, Family medicine, medicine.symptom, Colorectal Neoplasms, 0305 other medical science, business

الوصف: To investigate knowledge, values and preferences, and involvement among screening participants and non-participants in relation to colorectal cancer (CRC) and screening decision.Individuals (N = 2748) from the Screening of Swedish Colons trial were invited to respond to the SCREESCO questionnaire, assessing information/knowledge, values/preferences, and involvement.Respondents' (screening participants, n = 1320; non-participants, n = 161) knowledge varied across items; 90 % recognised faecal blood as a CRC symptom, but less than half cited overweight, smoking, alcohol, and physical inactivity as risk factors. Incidence and case fatality were often over- and underestimated, respectively (45 and 40 %). Non-participants were more uncertain about their CRC risk (p = 0.015) and less convinced that screening reduces the risk of dying from CRC (p0.001). In decision-making, screening participants took most into consideration the importance of early detection and CRC worry, and non-participants the risk of discomfort and complications due to the screening examination (p0.001). Most individuals made the decision without involving others.For informed and shared decisions, efforts need to be made to increase public knowledge about CRC and to develop interventions to support individuals in decision-making.These results can inform and guide future initiatives to facilitate high quality decisions and CRC screening uptake in Sweden.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2e73798a42a766bc3cea9727aa4472f2Test
https://doi.org/10.1016/j.pec.2020.09.005Test

المؤلفون: Michael J. Steinberg, Jaimee Reiley, Roseann Velez, Beverly Lang

المصدر: The Journal for Nurse Practitioners. 16:e143-e147

مصطلحات موضوعية: Advanced and Specialized Nursing, medicine.medical_specialty, Crc screening, Colorectal cancer, Practice patterns, Nurse practitioners, business.industry, Early detection, 030204 cardiovascular system & hematology, medicine.disease, digestive system diseases, 03 medical and health sciences, 0302 clinical medicine, Colorectal cancer screening, Slow progression, Family medicine, medicine, Survey data collection, 030212 general & internal medicine, business

الوصف: Colorectal cancer (CRC) is the second leading cause of cancer death in men and women in the United States. The opportunity for nurse practitioners (NPs) to initiate preventive measures to guide early detection of CRC is great given its slow progression. We present a collaborative project between a state NP association and colleagues from the Medical Affairs Division of a pharmaceutical company to develop an electronic survey to assess NP knowledge, beliefs, and practice patterns for CRC screening. Survey data identified that NP knowledge of CRC screening guidelines is variable and may contribute to low screening rates.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::13d388d42f09839412db374edcce0ed0Test
https://doi.org/10.1016/j.nurpra.2020.07.004Test

المؤلفون: Cynthia T Snyder, Patricia Bird

المصدر: Journal of the American Association of Nurse Practitioners. 32:551-554

مصطلحات موضوعية: Oncology, medicine.medical_specialty, Chemotherapy, 030504 nursing, Colorectal cancer, Crc screening, business.industry, medicine.medical_treatment, Thyroid, Childhood cancer, MEDLINE, General Medicine, Primary care, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Internal medicine, medicine, 030212 general & internal medicine, Abdominal radiotherapy, 0305 other medical science, business, General Nursing

الوصف: Childhood cancer survivors (CCSs) are at an increased risk for secondary cancers, including colorectal, thyroid, lung, and breast. Treatment with abdominal radiotherapy and/or alkylating agent chemotherapy has been associated with an increased risk for colorectal adenomas and colorectal cancer (CRC) in CCSs. The phenotype of therapy-associated polyposis (TAP) is not well-understood, given the paucity of cases described in the literature. Further defining the phenotype of TAP is important to increase the primary care provider's awareness of when to begin CRC screening in these patients. We present a case of a patient with possible acquired polyposis that seems to meet the criteria identified in the literature for TAP. The purpose of this case study is to add to the body of knowledge related to TAP, further defining the phenotype. Better understanding of therapy-related risks in CCSs and hereditary predisposition will provide primary care providers and their patients with an improved plan for CRC screening.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6fdbda78c16540689d31d4dad0f6c9f5Test
https://doi.org/10.1097/jxx.0000000000000474Test

المؤلفون: Craig Kuziemsky, Heather Smith, Robin P. Boushey, Peyman Varshoei

المصدر: Journal of the American Medical Informatics Association : JAMIA

مصطلحات موضوعية: model validation, medicine.medical_specialty, Computer science, Clinical Decision-Making, Health Informatics, Research and Applications, Markov model, colorectal cancer screening, decision making, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Computer Simulation, Medical physics, simulation modeling, 030212 general & internal medicine, Grading (education), Early Detection of Cancer, Reliability (statistics), Modalities, Impact assessment, Crc screening, Simulation modeling, Reproducibility of Results, 3. Good health, Colorectal cancer screening, 030220 oncology & carcinogenesis, Colorectal Neoplasms

الوصف: Objective This study sought to assess the impact and validity of simulation modeling in informing decision making in a complex area of healthcare delivery: colorectal cancer (CRC) screening. Materials and Methods We searched 10 electronic databases for English-language articles published between January 1, 2008, and March 1, 2019, that described the development of a simulation model with a focus on average-risk CRC screening delivery. Included articles were reviewed for evidence that the model was validated, and provided real or potential contribution to informed decision making using the GRADE EtD (Grading of Recommendations Assessment, Development, and Evaluation Evidence to Decision) framework. Results A total of 43 studies met criteria. The majority used Markov modeling (n = 31 [72%]) and sought to determine cost-effectiveness, compare screening modalities, or assess effectiveness of screening. No study reported full model validation and only (58%) reported conducting any validation. Majority of models were developed to address a specific health systems or policy question; few articles report the model’s impact on this decision (n = 39 [91%] vs. n = 5 [12%]). Overall, models provided evidence relevant to every element important to decision makers as outlined in the GRADE EtD framework. Discussion and Conclusion Simulation modeling contributes evidence that is considered valuable to decision making in CRC screening delivery, particularly in assessing cost-effectiveness and comparing screening modalities. However, the actual impact on decisions and validity of models is lacking in the literature. Greater validity testing, impact assessment, and standardized reporting of both is needed to understand and demonstrate the reliability and utility of simulation modeling.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::082cd8d7e3493a70857eb0837ebf760bTest
https://doi.org/10.1093/jamia/ocaa022Test

المؤلفون: Jennifer Coury, Gloria D. Coronado, Beverly B. Green, Malaika Schwartz, Laura-Mae Baldwin, Imara I. West

المصدر: Journal of Community Health. 45:916-921

مصطلحات موضوعية: Male, Health plan, medicine.medical_specialty, Health (social science), Binomial regression, Primary care, Medicare, Ambulatory Care Facilities, Feces, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Postal Service, 030212 general & internal medicine, Health insurance plan, Early Detection of Cancer, Aged, Motivation, 030505 public health, Medicaid, Crc screening, business.industry, Public Health, Environmental and Occupational Health, Middle Aged, United States, Fecal Immunochemical Test, Occult Blood, Family medicine, Female, Colorectal Neoplasms, 0305 other medical science, business

الوصف: BeneFIT was a demonstration project that worked with a Medicaid/Medicare health plan to implement a mailed fecal immunochemical test (FIT) program. The goal was to reach age-eligible enrollees who were due for colorectal cancer (CRC) screening and prompt them to complete a FIT. One health insurance plan collaborated with six federally qualified health centers (FQHCs) in Oregon. Reach was defined as the percent of eligible individuals overdue for CRC screening who were mailed a FIT in 2016. We examined patient-level factors associated with reach, using multivariable log binomial regression and FIT completion rates at 6 months. The health plan identified 3386 age-eligible members overdue for CRC screening. Of these, 2615 (77.2%) were reached (mailed FIT kits) and 771 (22.8%) were not; 478 (14.1%) because they were not considered to be clinic patients and 290 (8.6%) because of mailing issues. Patient-level factors associated with not being reached were: being male, being Medicaid-insured (vs. Medicare), and having no primary care visits (vs. 4+ visits) in the last year. Among all enrollees identified as overdue for CRC screening, FIT completion rates at 6 months were 14.8% overall and 18.5% in the subgroup reached. In a mailed FIT program, a health insurance plan attempted to reach as many enrollees overdue for CRC screening as possible, however 22.8% were not mailed a FIT. Additional efforts are needed to ensure that the hardest to reach enrollees can participate in CRC screening.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::27e381d124b2b172d8afc6bf483d3950Test
https://doi.org/10.1007/s10900-020-00809-9Test

المؤلفون: Linda N. Douma, Ellen Uiters, Danielle R. M. Timmermans

المساهمون: Public and occupational health, CCA - Cancer Treatment and quality of life, APH - Quality of Care, APH - Personalized Medicine

المصدر: BMC Psychology, Vol 8, Iss 1, Pp 1-11 (2020)
Douma, L N, Uiters, E & Timmermans, D R M 2020, ' Decision-making styles in the context of colorectal cancer screening ', BMC Psychology, vol. 8, no. 1, 11 . https://doi.org/10.1186/s40359-020-0381-1Test
BMC Psychology, 8(1):11. BioMed Central
BMC Psychology

مصطلحات موضوعية: Male, Decision Making, Population, lcsh:BF1-990, Health literacy, Context (language use), Decisional conflict, CRC screening, Social group, Cancer screening, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Humans, Mass Screening, 030212 general & internal medicine, education, Early Detection of Cancer, General Psychology, Aged, Response rate (survey), education.field_of_study, 030503 health policy & services, Psychological research, General Medicine, Middle Aged, Colorectal cancer, lcsh:Psychology, Female, Decision-making styles, Colorectal Neoplasms, 0305 other medical science, Psychology, Research Article, Clinical psychology, Decision-making

الوصف: Background Our study examined the use of decision-making styles, as identified by Scott and Bruce (1995) (i.e. differentiating between a rational, intuitive, dependent, avoidant and spontaneous decision-making style), within the context of colorectal cancer (CRC) screening participation. In the field of cancer screening, informed decision-making is considered important, which follows the Rational Decision model. Subsequently, gaining more insight into decision-making styles being used in real life, could improve support to people when making their screening decision. In addition, we examined whether the decision-making style that people used was associated with their experienced decisional conflict. Methods An online survey was carried out among a sample of first-time CRC screening invitees (1282 respondents, response rate 49%). We assessed people’s decision-making styles, CRC screening participation, education level, self-reported health literacy, and decisional conflict, and examined the possible associations between them. Results In our study, people who had to decide about CRC screening scored high on using both a rational and intuitive decision-making style. Respondents scoring higher on using a spontaneous or dependent decision-making style were more likely to have participated in CRC screening, while respondents scoring higher on using an avoidant decision-making style were more likely not to have participated in CRC screening. However, differences were small. Generally, people in our study experienced low decisional conflict. Conclusion Our eligible CRC screening population scored high on using both a rational and intuitive decision-making style. To optimise support to people, public education materials could be appealing more to the intuitive processes at hand. That being said, the current education materials aimed at informed/rational decision-making do not necessarily seem to create a problem, as people generally experienced low decisional conflict. Possible concerns regarding the use of a spontaneous, dependent or avoidant decision-making style could be that these styles might be contributing to less informed decisions. However, it is relevant to consider that the found differences are small and that any possible concern applies to a relatively small group of people.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e26b43d3d0e32824f93c9a18982b69c2Test
https://doaj.org/article/6e79e3d32c6849fe8ee67445286dde64Test

المؤلفون: José María Remes-Troche, Katherine Van Loon, A. Meixueiro-Daza, Martin Lajous, Priscilla Espinosa-Tamez, Gabriela Hinojosa-Garza, P Grube-Pagola, Michael B. Potter

المصدر: Family Practice

مصطلحات موضوعية: Male, medicine.medical_specialty, Epidemiology, Colorectal cancer, Biopsy, Colonoscopy, occult blood, Hemoglobins, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Screening programs, Humans, 030212 general & internal medicine, AcademicSubjects/MED00780, Mexico, Aged, medicine.diagnostic_test, business.industry, Crc screening, Immunochemistry, Middle Aged, colorectal neoplasms, medicine.disease, Predictive value, early detection of cancer, Test (assessment), Colorectal cancer screening, 030220 oncology & carcinogenesis, Female, Family Practice, business, Healthcare system

الوصف: Background In middle-income countries, the burden of colorectal cancer (CRC) is increasing in parallel with resources for diagnosis and treatment. There is a potential benefit of CRC screening programs in Mexico. Objective Since there are no organized screening programs in the country, we explored the willingness of individuals to complete a faecal immunochemical testing (FIT) based CRC screening program and its potential benefit in Mexico. Methods We conducted a CRC screening program pilot in Veracruz, Mexico, during 2015–16 using FIT. Individuals with FIT results >100 ng of haemoglobin/ml buffer were referred for diagnostic colonoscopy. Results Of 473 FIT kits distributed to adults aged 50–75, 85.8% (406) were completed by participants and analysed in the laboratory. Of these, 5.9% (24/406) of test results showed >100 ng haemoglobin/ml. Twenty-one participants completed colonoscopy. The positive predictive value of FIT >100 ng haemoglobin/ml for premalignant lesions was 33%. Conclusion These results provide preliminary evidence of the willingness of individuals to complete FIT-based CRC screening program in Mexico. However, further evaluation of health systems resources will be needed prior to large-scale implementation of CRC screening programs.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3750a71f81b5ae85ede467a504f110a9Test
https://doi.org/10.1093/fampra/cmz078Test

المؤلفون: Sherri Sheinfeld Gorin

المصدر: The Annals of Family Medicine. 17:386-389

مصطلحات موضوعية: Oncology, medicine.medical_specialty, Screening test, Colorectal cancer, Time-to-Treatment, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Global health, Humans, Medicine, 030212 general & internal medicine, Stage (cooking), Referral and Consultation, neoplasms, Original Research, Primary Health Care, business.industry, Crc screening, Treatment delay, medicine.disease, digestive system diseases, Colonic Neoplasms, Risk of death, Colorectal Neoplasms, Family Practice, business, Stage at diagnosis

الوصف: PURPOSE: An optimal diagnostic process in primary care is pivotal for reducing cancer-related disease burden. This study aims to explore reasons for long times to referral for Dutch colorectal cancer (CRC) patients in primary care. METHODS: A retrospective cohort study of anonymized free-text primary care records from the Julius General Practitioners’ Network database, linked to the Netherlands Cancer Registry. Patients with a confirmed CRC diagnosis from 2007 through 2011 that symptomatically presented in primary care were included. Median time and interquartile ranges from presentation in primary care to referral were calculated for multiple patient and presentation characteristics. Associations of these characteristics with long time to referral (75th percentile was ≥59 days) were examined with log-binomial regression analyses. Routes to referral of patients with the longest times to referral were explored using thematic free-text analyses (90th percentile at ≥219 days). RESULTS: Among the 309 people with CRC, patients who were female, did not have a registered family history, had a history of malignancy, lacked alarm symptoms at presentation, or had hemorrhoids at physical examination were at risk for longer time to referral in univariable analyses (longer median durations and/or univariable association with the 75th percentile). Only presentation without alarm symptoms showed a statistically significant association with long duration (75th percentile) in multivariable analysis (relative risk = 1.7; 95% CI, 1.1-2.6). Thematic exploration of the diagnostic routes to referral of patients with the longest durations (90th percentile) showed 2 dominating themes: “alternative working diagnosis” and “suboptimal diagnostic strategies,” and included the sub-themes “omitting to reconsider an initial diagnosis” and “lacking follow-up.” CONCLUSIONS: Long time to referral for CRC in primary care is mainly related to low cancer suspicion. There is potential for reducing the longest times to referral for patients with CRC in primary care, with earlier reconsideration of the initial hypothesis and implementation of strict follow-up consultations.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f97a1154378dfebb34a5c966769d49c3Test
https://doi.org/10.1370/afm.2454Test

المؤلفون: Thomas F. Imperiale, Marianne S. Matthias

المصدر: BMC Family Practice
BMC Family Practice, Vol 21, Iss 1, Pp 1-8 (2020)

مصطلحات موضوعية: Male, medicine.medical_specialty, Colorectal cancer, Colonoscopy, Risk Assessment, Grounded theory, CRC screening, Cancer prevention, Risk prediction tools, 03 medical and health sciences, 0302 clinical medicine, Qualitative research, Clinical Decision Rules, medicine, Decision aids, Humans, 030212 general & internal medicine, Veterans Affairs, Early Detection of Cancer, Aged, Neoplasm Staging, lcsh:R5-920, medicine.diagnostic_test, Crc screening, business.industry, Communication Barriers, Reproducibility of Results, Middle Aged, medicine.disease, Data Accuracy, Social Perception, Implementation, 030220 oncology & carcinogenesis, Family medicine, Female, lcsh:Medicine (General), Colorectal Neoplasms, Family Practice, business, Research Article

الوصف: Background Despite proven effectiveness of colorectal cancer (CRC) screening, at least 35% of screen-eligible adults are not current with screening. Decision aids and risk prediction tools may help increase uptake, adherence, and efficiency of CRC screening by presenting lower-risk patients with options less invasive than colonoscopy. The purpose of this qualitative study was to determine patient and provider perceptions of facilitators and barriers to use of a risk prediction tool for advanced colorectal neoplasia (CRC and advanced, precancerous polyps), to maximize its chances of successful clinical implementation. Methods We conducted qualitative, semi-structured interviews with patients aged 50–75 years who were not current with CRC screening, and primary care providers (PCPs) at an academic and a U.S. Department of Veterans Affairs Medical Center in the Midwest from October 2016 through March 2017. Participants were asked about their current experiences discussing CRC screening, then were shown the risk tool and asked about its acceptability, barriers, facilitators, and whether they would use it to guide their choice of a screening test. The constant comparative method guided analysis. Results Thirty patients and PCPs participated. Among facilitators were the tool’s potential to increase screening uptake, reduce patient risk, improve resource allocation, and facilitate discussion about CRC screening. PCP-identified barriers included concerns about the tool’s accuracy, consistency with guidelines, and time constraints. Conclusions Patients and PCPs found the risk prediction tool useful, with potential to increase uptake, safety, and efficiency of CRC screening, indicating potential acceptability and feasibility of implementation into clinical practice.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4e25de42b3372640a933e6d64e53b072Test
https://doi.org/10.1186/s12875-020-01113-0Test