Alexander Leonhard Braun1, Emanuele Prati1, Yonas Martin1, Charles Dvořák2, Kali Tal1, Nikola Biller-Andorno3, Jean-Luc Bulliard4, Jacques Cornuz4, Kevin Selby4,5, Reto Auer6,7. 1. Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland. 2. President Sentinella Network, Bern, Switzerland. 3. Institute for Biomedical Ethics and History of Medicine (IBME), Zurich, Switzerland. 4. University General Medicine and Public Health Centre, University of Lausanne, Lausanne, Switzerland. 5. Northern California Division of Research, Kaiser Permanente, Oakland, CA, USA. 6. Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland. Reto.Auer@biham.unibe.ch. 7. University General Medicine and Public Health Centre, University of Lausanne, Lausanne, Switzerland. Reto.Auer@biham.unibe.ch.
Abstract
OBJECTIVES: To determine the proportion of 50-75-year-old patients who visit a primary care physician's (PCP) office and were tested for colorectal cancer (CRC) by either colonoscopy within 10 years or fecal occult blood testing (FOBT) within 2 years. To describe the variation in care between PCPs and factors associated with these proportions. METHODS: Cross-sectional data collected between April and December 2017. PARTICIPANTS: PCPs reporting for the Swiss Sentinel Surveillance Network. Each PCP collected demographic data and CRC testing status from 40 consecutive patients. MEASUREMENTS: proportions of patients up to date with CRC screening and method used (colonoscopy/FOBT/Other); variation in the outcome measures between PCPs; association of physician-level factors with main outcomes. RESULTS: 91/129 PCPs collected data from 3451 patients; 45% had been tested for CRC within recommended intervals (41% colonoscopy, 4% FOBT). The proportions of patients tested and testing with colonoscopy versus FOBT varied widely between PCPs. Language region was associated with PCPs' rate of FOBT prescription. CONCLUSIONS: Less than half of patients who visited PCPs in Switzerland were tested for CRC within recommended intervals. PCPs varied widely in their testing practices.
OBJECTIVES: To determine the proportion of 50-75-year-old patients who visit a primary care physician's (PCP) office and were tested for colorectal cancer (CRC) by either colonoscopy within 10 years or fecal occult blood testing (FOBT) within 2 years. To describe the variation in care between PCPs and factors associated with these proportions. METHODS: Cross-sectional data collected between April and December 2017. PARTICIPANTS: PCPs reporting for the Swiss Sentinel Surveillance Network. Each PCP collected demographic data and CRC testing status from 40 consecutive patients. MEASUREMENTS: proportions of patients up to date with CRC screening and method used (colonoscopy/FOBT/Other); variation in the outcome measures between PCPs; association of physician-level factors with main outcomes. RESULTS: 91/129 PCPs collected data from 3451 patients; 45% had been tested for CRC within recommended intervals (41% colonoscopy, 4% FOBT). The proportions of patients tested and testing with colonoscopy versus FOBT varied widely between PCPs. Language region was associated with PCPs' rate of FOBT prescription. CONCLUSIONS: Less than half of patients who visited PCPs in Switzerland were tested for CRC within recommended intervals. PCPs varied widely in their testing practices.
Entities:
Keywords:
Colorectal cancer; Decision making; Practice variation; Primary care; Screening
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