BACKGROUND: Colorectal cancer (CRC) screening is a priority for the Veteran's Health Administration (VHA). Optimizing fecal occult blood testing (FOBT) is integral to CRC screening in health care systems. AIMS: The purpose of this study was to characterize the utilization of CRC testing in a large integrated health care system (VHA), determine current rates of CRC testing by FOBT and examine factors associated with lack of FOBT card return. METHODS: The VHA Office of Quality and Performance (OQP) collected data from a national sample of Veterans from October 2008 to September 2009. Rates and modality of CRC testing for eligible Veterans were calculated. Among those offered FOBT, bivariate analyses were performed to describe population characteristics by FOBT return. Logistic regression was used to determine factors independently associated with lack of FOBT return. RESULTS: A total of 36,336 Veterans were included. On weighted analysis, 80.4% of Veterans received a form of CRC screening. The majority underwent colonoscopy in the prior 10 years (71.6%), followed by FOBT in the prior year (24.0%). A total of 31.0% did not return FOBT cards that were provided. Factors associated with a lack of FOBT return included: younger age, female gender, non-Caucasian race, living in the Northeast, current smoking and lack of influenza vaccination. CONCLUSIONS: Overall rates of CRC screening in VHA are high. Systems-based practices within VHA likely play a role in successful CRC screening. CRC screening is most often via colonoscopy, followed by FOBT. Characteristics associated with non-adherence with FOBT may inform future quality improvement initiatives in health care systems.
BACKGROUND:Colorectal cancer (CRC) screening is a priority for the Veteran's Health Administration (VHA). Optimizing fecal occult blood testing (FOBT) is integral to CRC screening in health care systems. AIMS: The purpose of this study was to characterize the utilization of CRC testing in a large integrated health care system (VHA), determine current rates of CRC testing by FOBT and examine factors associated with lack of FOBT card return. METHODS: The VHA Office of Quality and Performance (OQP) collected data from a national sample of Veterans from October 2008 to September 2009. Rates and modality of CRC testing for eligible Veterans were calculated. Among those offered FOBT, bivariate analyses were performed to describe population characteristics by FOBT return. Logistic regression was used to determine factors independently associated with lack of FOBT return. RESULTS: A total of 36,336 Veterans were included. On weighted analysis, 80.4% of Veterans received a form of CRC screening. The majority underwent colonoscopy in the prior 10 years (71.6%), followed by FOBT in the prior year (24.0%). A total of 31.0% did not return FOBT cards that were provided. Factors associated with a lack of FOBT return included: younger age, female gender, non-Caucasian race, living in the Northeast, current smoking and lack of influenza vaccination. CONCLUSIONS: Overall rates of CRC screening in VHA are high. Systems-based practices within VHA likely play a role in successful CRC screening. CRC screening is most often via colonoscopy, followed by FOBT. Characteristics associated with non-adherence with FOBT may inform future quality improvement initiatives in health care systems.
Authors: Amal N Trivedi; Sierra Matula; Isomi Miake-Lye; Peter A Glassman; Paul Shekelle; Steven Asch Journal: Med Care Date: 2011-01 Impact factor: 2.983
Authors: Steven M Asch; Elizabeth A McGlynn; Mary M Hogan; Rodney A Hayward; Paul Shekelle; Lisa Rubenstein; Joan Keesey; John Adams; Eve A Kerr Journal: Ann Intern Med Date: 2004-12-21 Impact factor: 25.391
Authors: Robert A Smith; Vilma Cokkinides; Durado Brooks; Debbie Saslow; Otis W Brawley Journal: CA Cancer J Clin Date: 2010 Mar-Apr Impact factor: 508.702
Authors: K Allen Greiner; Aimee S James; Wendi Born; Sandra Hall; Kimberly K Engelman; Kolawole S Okuyemi; Jasjit S Ahluwalia Journal: Prev Med Date: 2005-08 Impact factor: 4.018
Authors: Ann G Zauber; Iris Lansdorp-Vogelaar; Amy B Knudsen; Janneke Wilschut; Marjolein van Ballegooijen; Karen M Kuntz Journal: Ann Intern Med Date: 2008-10-06 Impact factor: 25.391
Authors: Christian von Wagner; Gianluca Baio; Rosalind Raine; Julia Snowball; Stephen Morris; Wendy Atkin; Austin Obichere; Graham Handley; Richard F Logan; Sandra Rainbow; Stephen Smith; Stephen Halloran; Jane Wardle Journal: Int J Epidemiol Date: 2011-02-17 Impact factor: 7.196
Authors: Jeffrey K Lee; Veronica Reis; Shanglei Liu; Lorraine Conn; Erik J Groessl; Theodore G Ganiats; Samuel B Ho Journal: J Gen Intern Med Date: 2009-09-23 Impact factor: 5.128
Authors: Laura Frain; David Swanson; Kelly Cho; David Gagnon; Kun Ping Lu; Rebecca A Betensky; Jane Driver Journal: Alzheimers Dement Date: 2017-07-12 Impact factor: 21.566
Authors: Jill K Schinkel; Stephanie Shao; Shelia H Zahm; Katherine A McGlynn; Craig D Shriver; Kangmin Zhu Journal: Cancer Epidemiol Date: 2016-05-06 Impact factor: 2.984
Authors: Matthew A Goldshore; Shivan J Mehta; Woodrow Fletcher; George Tzanis; Chyke A Doubeni; E Carter Paulson Journal: Am J Prev Med Date: 2020-07 Impact factor: 5.043
Authors: Folasade P May; Elizabeth M Yano; Dawn Provenzale; W Neil Steers; Donna L Washington Journal: Dig Dis Sci Date: 2017-05-20 Impact factor: 3.199
Authors: Jennifer A Schlichting; Michelle A Mengeling; Nader M Makki; Ashish Malhotra; Thorvardur R Halfdanarson; J Stacey Klutts; Barcey T Levy; Peter J Kaboli; Mary E Charlton Journal: J Community Health Date: 2014-04
Authors: Leah L Zullig; George L Jackson; Morris Weinberger; Dawn Provenzale; Bryce B Reeve; William R Carpenter Journal: Clin Colorectal Cancer Date: 2013-08-27 Impact factor: 4.481