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Financial incentives, in the amount of $5 or $10 offered in exchange for responding to mailed invitation to complete FIT, do not impact CRC screening completion.

Background: Data on the number of individuals eligible for screening, and rates of screening, are necessary to assess national colorectal cancer screening efforts. Such data are sparse for safety-net health systems. Methods: A retrospective cohort study of individuals ages 50 to 75 served by a safety-net health system in Tarrant County, TX was conducted to determine (a) the size of the potential screen-eligible population ages 50 to 75, (b) the rate of screening over 5 years among individuals ages 54 to 75, and (c) the potential predictors of screening, including sex, race/ethnicity, insurance status, frequency of outpatient visits, and socioeconomic status. Results: Of 28,708 potential screen-eligible individuals, 20,416 were ages 54 to 75 and analyzed for screening; 22.0% were screened within the preceding 5 years. Female gender, Hispanic ethnicity, ages 65 to 75, insurance status, and two or more outpatient visits were indepen-

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Background Optimizing colorectal cancer (CRC) screening requires identification of unscreened individuals, and tracking screening trends. A recent NIH State of the Science Conference, “Enhancing Use and Quality of CRC Screening,” cited a need for more population data sources for measurement of CRC screening, particularly for the medically underserved. Medical claims data (claims data) are created and maintained by many health systems to facilitate billing for services rendered, and may be an efficient resource for identifying unscreened individuals. The aim of our study, conducted at a safety-net health system, was to determine whether CRC test use measured by claims data matches medical chart documentation. Methods We randomly selected 400 patients from a universe of 20,000 patients previously included in an analysis of CRC test use based on claims data 2002–2006 in Tarrant Co, TX. Claims data were compared with medical chart documentation by estimation of agreement and examination of test use over-/under-documentation. Results We found agreement on test use was very good for fecal occult blood testing (κ=0.83, 95% CI:0.75–0.90) and colonoscopy (κ=0.91, 95% CI:0.85–0.96), and fair for sigmoidoscopy (κ=0.39, 95% CI:0.28–0.49). Over- and under-documentation of the two most commonly used CRC tests―colonoscopy and FOBT―were rare. Conclusion Use of claims data by health systems to measure CRC test use is a promising alternative to measuring CRC test use with medical chart review, and may be used to identify unscreened patients for screening interventions, and track screening trends over time.

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