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Primary Care Research

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Colorectal cancer screening can be improved at primary care practices

Primary care practices don't screen eligible patients for colorectal cancer (CRC) as often as they do for breast and cervical cancer, though clinical practice guidelines have recommended CRC screening for more than 10 years. Several strategies have been proposed to effect changes in CRC screening rates in primary care practices. These include adopting a team approach to delivering care, utilizing health information technology, and eliciting patient preferences for specific CRC screening method.

David Lanier, M.D., from the Agency for Healthcare Research and Quality, and colleagues discussed strategies to improve screening rates for CRC in primary care settings during a conference in April 2005 that was cosponsored by AHRQ and the National Cancer Institute.

The group suggested that other members of the practice team, not just the doctor, could help boost CRC screening rates by determining screening eligibility and educating patients. Practices could also utilize electronic health records or other health information technology to identify and track patients who should be screened. Once patients were identified, they could be educated about the benefits of each available screening test and allowed to participate in deciding on the preferred test.

Currently, insurers do not pay practices for the time their staff spends educating patients, nor do they pay for telephone or E-mail reminders sent to patients eligible for screening. Conference attendees proposed that insurers begin reimbursing for these approaches to encourage their use in reaching patients who may need CRC screening. The strategies recommended at the conference require additional research to ensure their effectiveness in improving CRC screening. Once validated, each strategy could be used to improve primary care practices' screening services across the board.

See "Improving colorectal cancer screening in primary care practice: Innovative strategies and future directions," by Carrie N. Klabunde, Ph.D., Dr. Lanier, Erica S. Breslau, Ph.D., and others in the August 2007 Journal of General Internal Medicine (22), pp. 1195-1205.

Reprints (AHRQ Publication No. 08-R010) are available from the AHRQ Publications Clearinghouse.

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