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Current Oncology
Volume 24
Issue 1
10.3747/co.24.3025
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Article

A Centrally Generated Primary Care Physician Audit Report Does Not Improve Colonoscopy Uptake After a Positive Result on a Fecal Occult Blood Test in Ontario’s Coloncancercheck Program

by
D. Stock
1,*,
L. Rabeneck
2,3,4,5,6,
N.N. Baxter
3,5,7,8,
L.F. Paszat
3,4,9,
R. Sutradhar
3,4,
L. Yun
3 and
J. Tinmouth
2,3,5,6
1
Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
2
Department of Medicine, University of Toronto, Toronto, ON, Canada
3
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
4
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
5
Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
6
Cancer Care Ontario, Toronto, ON, Canada
7
Department of General Surgery and Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
8
Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
9
Oncology, University of Toronto, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2017, 24(1), 47-51; https://doi.org/10.3747/co.24.3025
Submission received: 11 October 2016 / Revised: 13 November 2016 / Accepted: 16 December 2016 / Published: 1 February 2017

Abstract

Background: Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario’s population-wide ColonCancerCheck Program. Methods: This prospective cohort study used data sets from Ontario’s ColonCancerCheck Program (2008–2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. Results: A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy (p for linear trend: <0.001). Conclusions: In a large population-wide setting, centralized tracking in the form of physician-targeted mailed audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.
Keywords: fecal occult blood test; colonoscopy; colorectal cancer; screening; program evaluation fecal occult blood test; colonoscopy; colorectal cancer; screening; program evaluation

Share and Cite

MDPI and ACS Style

Stock, D.; Rabeneck, L.; Baxter, N.N.; Paszat, L.F.; Sutradhar, R.; Yun, L.; Tinmouth, J. A Centrally Generated Primary Care Physician Audit Report Does Not Improve Colonoscopy Uptake After a Positive Result on a Fecal Occult Blood Test in Ontario’s Coloncancercheck Program. Curr. Oncol. 2017, 24, 47-51. https://doi.org/10.3747/co.24.3025

AMA Style

Stock D, Rabeneck L, Baxter NN, Paszat LF, Sutradhar R, Yun L, Tinmouth J. A Centrally Generated Primary Care Physician Audit Report Does Not Improve Colonoscopy Uptake After a Positive Result on a Fecal Occult Blood Test in Ontario’s Coloncancercheck Program. Current Oncology. 2017; 24(1):47-51. https://doi.org/10.3747/co.24.3025

Chicago/Turabian Style

Stock, D., L. Rabeneck, N.N. Baxter, L.F. Paszat, R. Sutradhar, L. Yun, and J. Tinmouth. 2017. "A Centrally Generated Primary Care Physician Audit Report Does Not Improve Colonoscopy Uptake After a Positive Result on a Fecal Occult Blood Test in Ontario’s Coloncancercheck Program" Current Oncology 24, no. 1: 47-51. https://doi.org/10.3747/co.24.3025

APA Style

Stock, D., Rabeneck, L., Baxter, N. N., Paszat, L. F., Sutradhar, R., Yun, L., & Tinmouth, J. (2017). A Centrally Generated Primary Care Physician Audit Report Does Not Improve Colonoscopy Uptake After a Positive Result on a Fecal Occult Blood Test in Ontario’s Coloncancercheck Program. Current Oncology, 24(1), 47-51. https://doi.org/10.3747/co.24.3025

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