Screening for Colorectal Cancer

Davidson, Karina W.; Barry, Michael J.; Mangione, Carol M.; Cabana, Michael D.; Caughey, Aaron B.; Davis, Esa M.; Donahue, Katrina E; Doubeni, Chyke A.; Krist, Alex H.; Kubik, Martha; Li, Li; Ogedegbe, Gbenga; Owens, Douglas K; Pbert, Lori; Silverstein, Michael; Stevermer, James J.; Tseng, Chien-Wen; Wong, John B.

doi:10.1001/jama.2021.6238

Cited by 969 publications

(87 citation statements)

References 32 publications

(73 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These strategies are all recommended but differ with respect to characteristics that could influence an individual's preference and adherence to that screening strategy. To ensure uptake of recommendations, the choice of screening strategy should depend on the individual's preferences, test availability, and the strategy that the patient is most likely to complete and adhere to [1,6,9]. The existing literature on preferences for screening strategies shows high variability in preferences across studies [10][11][12][13] and, since guidelines have previously recommended screening at age 50, few studies have included younger people or explicitly tested differences in preferences by age.…”

Section: Preferences For Screening Strategiesmentioning

confidence: 99%

“…We presented 3 distinct screening strategies as decision alternatives: colonoscopy every 10 years (an invasive test that allows for direct visualization of the colon), fecal immunochemical test (FIT) every year (a stool-based test that detects blood in the stool) and computed tomography colonography (CTC) every 5 years (a radiographic test). All screening strategies and intervals that we have selected for this study are recommended by the USPSTF [6].…”

Section: Hierarchy Developmentmentioning

confidence: 99%

“…In 2018, the American Cancer Society updated it's guidelines for colorectal cancer screening to address this trend in younger individuals and made a 'qualified' recommendation that averagerisk adults aged 45 or older should begin regular screening [1]. In May of 2021, the United States Preventive Services Task Force (USPSTF), an independent guidelineproducing organization whose recommendations influence clinical coverage and policy decisions, released their updated recommendation statement to initiate screening at age 45 [6]. This shift will add approximately 19 million individuals to the eligible CRC screening pool [7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process

Hyams

Golden

Sammarco³

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

Background In 2021, the United States Preventive Services Task Force updated their recommendation, stating that individuals ages 45-49 should initiate screening for colorectal cancer. Since several screening strategies are recommended, making a shared decision involves including an individual’s preferences. Few studies have included individuals under age 50. In this study, we use a multicriteria decision analysis technique called the Analytic Hierarchy Process to explore preferences for screening strategies and evaluate whether preferences vary by age. Methods Participants evaluated a hierarchy with 3 decision alternatives (colonoscopy, fecal immunochemical test, and computed tomography colonography), 3 criteria (test effectiveness, the screening plan, and features of the test) and 7 sub-criteria. We used the linear fit method to calculate consistency ratios and the eigenvector method for group preferences. We conducted sensitivity analysis to assess whether results are robust to change and tested differences in preferences by participant variables using chi-square and analysis of variance. Results Of the 579 individuals surveyed, 556 (96%) provided complete responses to the AHP portion of the survey. Of these, 247 participants gave responses consistent enough (CR < 0.18) to be included in the final analysis. Participants that were either white or have lower health literacy were more likely to be excluded due to inconsistency. Colonoscopy was the preferred strategy in those < 50 and fecal immunochemical test was preferred by those over age 50 (p = 0.002). These results were consistent when we restricted analysis to individuals ages 45-55 (p = 0.011). Participants rated test effectiveness as the most important criteria for making their decision (weight = 0.555). Sensitivity analysis showed our results were robust to shifts in criteria and sub-criteria weights. Conclusions We reveal potential differences in preferences for screening strategies by age that could influence the adoption of screening programs to include individuals under age 50. Researchers and practitioners should consider at-home interventions using the Analytic Hierarchy Process to assist with the formulation of preferences that are key to shared decision-making. The costs associated with different preferences for screening strategies should be explored further if limited resources must be allocated to screen individuals ages 45-49.

show abstract

Section: Preferences For Screening Strategiesmentioning

confidence: 99%

Section: Hierarchy Developmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process

Hyams

Golden

Sammarco³

et al. 2021

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Average-risk CRC screening can favorably impact the CRC public health burden by identifying patients with premalignant or localized malignant neoplasia for earlier, more effective intervention. National organizations such as the United States Preventive Services Task Force (USPSTF) in their 2021 Final Recommendation Statement and the American Cancer Society (ACS) recommend lowering the age for average-risk CRC screening (beginning at the age of 45 years) using one of several equally endorsed test options, including the multi-target stool DNA assay [3][4][5] (mt-sDNA; marketed as Cologuard®; Exact Sciences, Madison, WI). Since receiving approval from the US Food and Drug Administration in August 2014, the mt-sDNA assay has been prescribed by over 200,000 providers and completed by more than 4 million patients nationwide.…”

Section: Introductionmentioning

confidence: 99%

Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a large, nationally insured cohort

Miller‐Wilson

Rutten

Thomme

et al. 2021

Int J Colorectal Dis

View full text Add to dashboard Cite

Purpose Colorectal cancer (CRC) is the second most deadly cancer in the USA. Early detection can improve CRC outcomes, but recent national screening rates (62%) remain below the 80% goal set by the National Colorectal Cancer Roundtable. Multiple options are endorsed for average-risk CRC screening, including the multi-target stool DNA (mt-sDNA) test. We evaluated cross-sectional mt-sDNA test completion in a population of commercially and Medicare-insured patients. Methods Participants included individuals ages 50 years and older with commercial insurance or Medicare, with a valid mt-sDNA test shipped by Exact Sciences Laboratories LLC between January 1, 2018, and December 31, 2018 (n = 1,420,460). In 2020, we analyzed cross-sectional adherence, as the percent of successfully completed tests within 365 days of shipment date. Results Overall cross-sectional adherence was 66.8%. Adherence was 72.1% in participants with Traditional Medicare, 69.1% in participants with Medicare Advantage, and 61.9% in participants with commercial insurance. Adherence increased with age: 60.8% for ages 50–64, 71.3% for ages 65–75, and 74.7% for ages 76 + years. Participants with mt-sDNA tests ordered by gastroenterologists had a higher adherence rate (78.3%) than those with orders by primary care clinicians (67.2%). Geographically, adherence rates were highest among highly rural patients (70.8%) and ordering providers in the Pacific region (71.4%). Conclusions Data from this large, national sample of insured patients demonstrate high cross-sectional adherence with the mt-sDNA test, supporting its role as an accepted, noninvasive option for average-risk CRC screening. Attributes of mt-sDNA screening, including home-based convenience and accompanying navigation support, likely contributed to high completion rates.

show abstract

“…Primary prevention entails lifestyle and dietary modifications. Secondary prevention in asymptomatic individuals (screening) is recommended at ages 45 and older [2]. Colon capsule endoscopy/capsule colonoscopy (CCE) utilizes a small capsule to observe the mucosa of the colon and rectum.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy for Per-Patient Polyp Detection of Second-Generation Capsule Endoscopy Compared to Colonoscopy: A Meta-Analysis of Multicenter Studies

Ali¹,

Pamarthy²,

Sarfraz³

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

Screening for Colorectal Cancer

Cited by 969 publications

References 32 publications

Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process

Evaluating preferences for colorectal cancer screening in individuals under age 50 using the Analytic Hierarchy Process

Cross-sectional adherence with the multi-target stool DNA test for colorectal cancer screening in a large, nationally insured cohort

Diagnostic Accuracy for Per-Patient Polyp Detection of Second-Generation Capsule Endoscopy Compared to Colonoscopy: A Meta-Analysis of Multicenter Studies

Contact Info

Product

Resources

About