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25.01.2019 | Original Research

Factors Affecting Adherence in a Pragmatic Trial of Annual Fecal Immunochemical Testing for Colorectal Cancer

verfasst von: Carrie M. Nielson, PhD, William M. Vollmer, PhD, Amanda F. Petrik, MS, Erin M. Keast, MS, Beverly B. Green, MD, Gloria D. Coronado, PhD

Erschienen in: Journal of General Internal Medicine | Ausgabe 6/2019

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Abstract

Background

Colorectal cancer screening by fecal immunochemical test (FIT) reduces the burden of colorectal cancer. However, effectiveness relies on annual adherence, which presents challenges for clinic staff and patients.

Objective

Describe FIT return rates and identify factors associated with FIT adherence over 2 years in a mailed FIT outreach program in federally qualified health centers.

Design

Observational study nested in the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) trial. Five thousand one hundred ninety-five patients had an initial FIT order and were followed for ≥ 2 years (3574 also had a FIT order in the second year).

Main Measures

FIT return percent in each year and patient- and neighborhood-level characteristics associated with FIT adherence.

Key Results

Overall, the proportion of FIT orders that were completed was 46% in the patients’ first year and 41% in the patients’ second year. Of the 5195 patients with a FIT order in year 1, 3574 (69%) also had a FIT order in year 2 (71% of year 1 adherers and 67% of year 1 non-adherers, p = 0.009). Among those with a FIT order in the second year, the FIT return rate was about twice as high among those who were adherent in the first year (952/1674, or 57%) as among those who were not (531/1900, or 28%, p < 0.0001). Patient-level characteristics associated with higher odds of FIT return were a history of FIT screening at baseline, age over 65 (vs 50–65), no current tobacco use, recent receipt of a mammogram or flu vaccine, Asian ancestry (compared to non-Hispanic white), and non-English preference. The only neighborhood factor associated with lower FIT return rate was patient’s larger residential city size.

Conclusion

Our findings can inform the customization of programs to promote FIT return among patients who receive care at federally qualified health centers.

Trial Registration

http://www.clinicaltrials.gov

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Titel: Factors Affecting Adherence in a Pragmatic Trial of Annual Fecal Immunochemical Testing for Colorectal Cancer
verfasst von: Carrie M. Nielson, PhD
William M. Vollmer, PhD
Amanda F. Petrik, MS
Erin M. Keast, MS
Beverly B. Green, MD
Gloria D. Coronado, PhD
Publikationsdatum: 25.01.2019
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 6/2019
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-018-4820-0

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Factors Affecting Adherence in a Pragmatic Trial of Annual Fecal Immunochemical Testing for Colorectal Cancer

Abstract

Background

Objective

Design

Main Measures

Key Results

Conclusion

Trial Registration

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Objective

Design

Main Measures

Key Results

Conclusion

Trial Registration

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