Gloria D Coronado1, Carrie M Nielson2, Erin M Keast2, Amanda F Petrik2, Jerry M Suls3. 1. Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA. gloria.d.coronado@kpchr.org. 2. Kaiser Permanente Center for Health Research, 3800 N. Interstate Avenue, Portland, OR, 97227, USA. 3. Center for Personalized Health, Feinstein Institute for Medical Research, New York, NY, 10022, USA.
Abstract
PURPOSE: Patients' chronic disease burden can influence the likelihood that providers will recommend cancer screening and that patients will participate in it. Using data from the STOP CRC pragmatic study, we examined associations between chronic disease burden and colorectal cancer screening recommendation and use. METHODS: Participating STOP CRC clinics (n = 26) received either usual care or training to implement a mailed fecal immunochemical test (FIT) outreach program. Selected clinic patients (n = 60,187 patients) were aged 50-74 and overdue for colorectal cancer screening. We used logistic regression to examine the associations between FIT recommendations and completion and patients' chronic disease burden, calculated using the Charlson Comorbidity Index and the Chronic Illness and Disability Payment System. RESULTS: For each index, FIT recommendation odds were 8-9% higher among individuals with minimal chronic disease burden and 13-23% lower among individuals with high chronic disease burden (inverted U-shaped association). Among adults who were ordered a FIT, FIT completion odds were 20% lower for individuals with any, versus no, chronic condition and diminished with increasing disease burden (inverse linear association). CONCLUSIONS: Analysis showed an inverted U-shaped association between patients' chronic disease burden and providers' recommendation of a FIT and an inverse linear association between patients' chronic disease burden and FIT completion. ClinicalTrials.gov registration: NCT01742065.
PURPOSE: Patients' chronic disease burden can influence the likelihood that providers will recommend cancer screening and that patients will participate in it. Using data from the STOP CRC pragmatic study, we examined associations between chronic disease burden and colorectal cancer screening recommendation and use. METHODS: Participating STOP CRC clinics (n = 26) received either usual care or training to implement a mailed fecal immunochemical test (FIT) outreach program. Selected clinic patients (n = 60,187 patients) were aged 50-74 and overdue for colorectal cancer screening. We used logistic regression to examine the associations between FIT recommendations and completion and patients' chronic disease burden, calculated using the Charlson Comorbidity Index and the Chronic Illness and Disability Payment System. RESULTS: For each index, FIT recommendation odds were 8-9% higher among individuals with minimal chronic disease burden and 13-23% lower among individuals with high chronic disease burden (inverted U-shaped association). Among adults who were ordered a FIT, FIT completion odds were 20% lower for individuals with any, versus no, chronic condition and diminished with increasing disease burden (inverse linear association). CONCLUSIONS: Analysis showed an inverted U-shaped association between patients' chronic disease burden and providers' recommendation of a FIT and an inverse linear association between patients' chronic disease burden and FIT completion. ClinicalTrials.gov registration: NCT01742065.
Entities:
Keywords:
Charlson comorbidity index; Chronic Illness and Disability Payment System; Colorectal cancer screening; Federally qualified health centers; Multiple chronic conditions
Authors: Abbey Diaz; Jimin Kang; Suzanne P Moore; Peter Baade; Danette Langbecker; John R Condon; Patricia C Valery Journal: Cancer Epidemiol Date: 2017-01-10 Impact factor: 2.984
Authors: Mitchell T Heflin; Kathryn I Pollak; Maragatha N Kuchibhatla; Laurence G Branch; Eugene Z Oddone Journal: J Gerontol A Biol Sci Med Sci Date: 2006-08 Impact factor: 6.053
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Sara J T Guilcher; Aisha Lofters; Richard H Glazier; Susan B Jaglal; Jennifer Voth; Ahmed M Bayoumi Journal: Prev Med Date: 2014-07-27 Impact factor: 4.018
Authors: Hyunsoon Cho; Carrie N Klabunde; K Robin Yabroff; Zhuoqiao Wang; Angela Meekins; Iris Lansdorp-Vogelaar; Angela B Mariotto Journal: Ann Intern Med Date: 2013-11-19 Impact factor: 25.391
Authors: Tyler J OʼNeill; Joseph D Nguemo; Anne-Marie Tynan; Ann N Burchell; Tony Antoniou Journal: J Acquir Immune Defic Syndr Date: 2017-08-01 Impact factor: 3.731