Monday, March 4, 2013 (Last Updated: 03/05/2013)
Chyke A. Doubeni, M.D., M.P.H., of the University of Pennsylvania in Philadelphia, and colleagues examined the effectiveness of screening colonoscopy using data from 1,039 average-risk adults enrolled in four U.S. health plans. In analyses restricted to 471 eligible case patients and 509 matched controls, the researchers found that 2.8 percent of case patients and 9.0 percent of controls had undergone screening colonoscopy (adjusted odds ratios, 0.29 for any late-stage CRC; 0.36 for right colon cancer; and 0.26 for left colon/rectum cancer). The odds of overall CRC and left colon cancer, but not right colon cancer, were significantly reduced with sigmoidoscopy.
Beverly B. Green, M.D., M.P.H., of the University of Washington School of Medicine in Seattle, and colleagues assessed whether interventions using EHRs, automated mailings, and stepped increases in support improved adherence to CRC screening over two years among 4,675 adults aged 50 to 73 years not current for CRC screening. The interventions included usual care; EHR-linked mailings; EHR-linked mailings with telephone assistance; or EHR-linked mailings, telephone assistance, and nurse navigation. The researchers found that participants in intervention groups were significantly more likely to be current for CRC screening for both years, compared with usual care.
"Compared with usual care, a centralized, EHR-linked, mailed CRC screening program led to twice as many persons being current for screening over two years," Green and colleagues write. "Assisted and navigated interventions led to smaller but significant stepped increases compared with the automated intervention only. The rapid growth of EHRs provides opportunities for spreading this model broadly."