Pan-Canadian Initiatives in Colorectal Cancer Screening: Adopting Knowledge Translation Tools to Accelerate Uptake and Impact

Abstract

Background: Despite the positive conclusions of several randomized controlled trials and the publication of national recommendations on colorectal cancer (crc) screening, uptake remained low. The inauguration of the National Colorectal Cancer Screening Network in 2007, the same year that the first screening program was announced in Canada, provided an opportunity for integrated knowledge translation to accelerate the processes of program implementation and screening uptake. Aim: Two primary aims were identified. The first focused on means to monitor the effects of various implementation plans in delivering high-quality population-based crc screening. The second focused on identifying and addressing knowledge gaps that may impair screening participation. Method: The methods used are described in the context of the knowledge-to-action cycle and demonstrate that the initiative itself dictates the point in the cycle at which to start. Results: The identified need to monitor various implementation plans resulted in the shared development of a quality determinants document. All programs committed to designing data collection so that core components could be measured and compared; 6 operating programs have conducted the first data collection, which will allow for monitoring and for new knowledge creation as the process develops further. The knowledge gap identification project started with new knowledge creation, which identified a higher-than-expected willingness of Canadians to discuss crc screening with physicians, but a low level of understanding of screening as a wellness-related behaviour. Knowledge translation interventions have been developed with the stakeholders to address those gaps, and ongoing surveys to be carried out later in 2011 will help to gauge progress in the understanding and acceptance of crc screening by the population. Conclusions: A national network that engaged all programs, policymakers, experts, and lay representatives successfully used knowledge translation principles to enhance the trajectory of crc screening in Canada.

Patterns and predictors of adherence to colorectal cancer screening recommendations in Alberta’s Tomorrow Project participants stratified by risk

“…Despite the release of the Canadian Task Force screening recommendations in 2001, screening rates remained low among adults 50–74 years in the CCHS conducted 2 years after the recommendations were published [ 37 ]. To understand what might be impairing screening participation, a random digit dialing survey of 2500 Canadians aged 50–74 years found most respondents believed CRC screening was important; however, only 40% understood that CRC screening should be done even when asymptomatic [ 38 ]. Physicians were reported to have pessimistic expectations on patients’ compliance to CRC screening [ 39 ], however, Bryant et al [ 38 ] reported high willingness among patients to talk with a health-care provider about screening.…”

“…To understand what might be impairing screening participation, a random digit dialing survey of 2500 Canadians aged 50–74 years found most respondents believed CRC screening was important; however, only 40% understood that CRC screening should be done even when asymptomatic [ 38 ]. Physicians were reported to have pessimistic expectations on patients’ compliance to CRC screening [ 39 ], however, Bryant et al [ 38 ] reported high willingness among patients to talk with a health-care provider about screening. This gap between physician perspectives and expectations on one side, and actual patient attitudes on the other, represents a potential target to increase screening participation and appropriateness.…”

Integrated Knowledge Translation with Public Health Policy Makers: A Scoping Review

“…Authors' descriptions of KU involvement across all aspects of the iKT research were often unclear, making it difficult to discern the level of engagement. Based on unequivocal descriptions of involvement, KUs helped to: (1) develop research questions (Bornstein et al 2017;Bullock et al 2010;Hayden et al 2015;Naqshbandi Hayward et al 2016;Oelke et al 2015;Pelletier et al 2011;Valaitis et al 2012), (2) inform methods (Bornstein et al 2017;Bryant et al 2011;Bullock et al 2010;Fortin et al 2016;Hayden et al 2015;Henderson et al 2013Henderson et al , 2014Iyer et al 2015;McGrath et al 2009;Porter et al 2012;Wathen et al 2011;Welch et al 2015), 3collect and analyze data (Boivin et al 2011;Bornstein et al 2017;Bryant et al 2011;Fortin et al 2016;Iyer et al 2015;Naqshbandi Hayward et al 2016;Porter et al 2012;Valaitis et al 2012), (4) interpret results and craft the overall message (Boivin et al 2011;Bornstein et al 2017;Bullock et al 2010;Fortin et al 2016;Hayden et al 2015;Kothari et al 2014b;Naqshbandi Hayward et al 2016;Oelke et al 2015;Porter et al 2012;Valaitis et al 2012;Wathen et al 2011); and (5) share f...…”

A retrospective analysis of the role of proton pump inhibitors on colorectal cancer disease survival.

“…Although incidence and overall mortality rates for crc have been declining since the early 1990s, it is estimated that more than 160,000 new cases and 50,000 deaths occur across North America each year [1][2][3] . Changes in rates over time have been specifically influenced by the implementation and use of crc screening tests, the development of novel therapeutic regimens for crc, and the identification of modifiable risk factors associated with crc 4 .…”