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Primary care colorectal cancer screening correlates with breast cancer screening: implications for colorectal cancer screening improvement interventions

机译:初级保健结肠直肠癌筛查与乳腺癌筛查相关:对结肠直肠癌筛查改善干预措施的意义

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Objective National colorectal cancer (CRC) screening rates have plateaued. To optimize interventions targeting those unscreened, a better understanding is needed of how this preventive service fits in with multiple preventive and chronic care needs managed by primary care providers (PCPs). This study examines whether PCP practices of other preventive and chronic care needs correlate with CRC screening. Methods We performed a retrospective cohort study of 90 PCPs and 33,137 CRC screening-eligible patients. Five PCP quality metrics (breast cancer screening, cervical cancer screening, HgbA1c and LDL testing, and blood pressure control) were measured. A baseline correlation test was performed between these metrics and PCP CRC screening rates. Multivariable logistic regression with clustering at the clinic-level estimated odds ratios and 95% confidence intervals for these PCP quality metrics, patient and PCP characteristics, and their relationship to CRC screening. Results PCP CRC screening rates have a strong correlation with breast cancer screening rates ( r?=? 0.7414, p?
机译:目的全国大肠癌(CRC)筛查率已达到稳定水平。为了优化针对未筛查者的干预措施,需要更好地了解这种预防服务如何与由初级保健提供者(PCP)管理的多种预防和长期护理需求相适应。这项研究检查了其他预防和慢性护理需求的PCP做法是否与CRC筛查相关。方法我们对90名PCP和33,137名CRC筛查合格患者进行了回顾性队列研究。测量了五种PCP质量指标(乳腺癌筛查,宫颈癌筛查,HgbA1c和LDL测试以及血压控制)。在这些指标和PCP CRC筛查率之间进行了基线相关性测试。对这些PCP质量指标,患者和PCP特征及其与CRC筛查的关系,在临床水平上估计的优势比和95%置信区间上进行聚类的多变量logistic回归。结果PCP CRC筛查率与乳腺癌筛查率密切相关(r = = 0.414,p <0.001),而与其他质量指标的相关性较弱。在最终调整后的模型中,唯一可以显着预测CRC筛查的PCP质量指标是乳腺癌筛查(OR 1.25; 95%CI 1.11-1.42; p <0.001)。结论PCP CRC筛查率与乳腺癌筛查高度一致。 CRC筛查与子宫颈癌筛查和慢性疾病管理指标之间的一致性很弱。针对PCP以增加CRC筛查率的努力可以与乳腺癌筛查改善干预措施捆绑在一起,以增加其影响和成功率。

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