Update in office management
Using Quality Improvement Techniques to Increase Colon Cancer Screening

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Abstract

Screening has been shown to be effective and cost-effective in reducing the incidence of, and mortality from, colorectal cancer. Despite its demonstrated efficacy, colon cancer screening remains underused, with fewer than 60% of age-eligible adults reporting being up to date with recommended screening tests. Several factors account for the low rates of utilization, including patient, provider and system-related issues. Several interventions have been shown to be effective in overcoming these barriers, including the use of patient decision aids. Patient decision aids are tools designed to provide information to patients about screening options, help them consider the pros and cons of the alternatives, and assist them to reach a decision consistent with their values. The use of decision aids in clinical practice can increase screening rates by up to 14 percentage points. Mailing the decision aids to patients in advance of office visits appears to be a cost-effective means of implementation.

Section snippets

Interventions to Increasing CRC Screening

A wide variety of interventions have been tested with respect to their ability to increase use of CRC screening. (Table) Our main focus has been the use of patient decision aids. Patient decision aids are tools that have been systematically developed to encourage better decision-making processes. They help alert the patient about the relevance of the health issue; allow consideration of options, and their benefits and downsides, and help patients make a decision concordant with his or her

Acknowledgments

The authors would like to thank Jennifer Griffith and Rachael Scheinman for their help in preparing this manuscript.

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Funding: Dr. Pignone and Dr. Lewis are supported by research grants from the Foundation for Informed Medical Decision Making. Dr. Lewis is supported by a K07 Mentored Career Development Award and Dr. Pignone by a K05 Established Investigator Award (5K07CA104128 and 1K05CA129166, respectively) from the National Cancer Institute.

Conflict of Interest: None.

Authorship: All authors had access to the data and a role in writing this manuscript.

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