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HSR&D 2004 National Meeting Abstracts

1065. Intervention to Increase Colorectal Cancer Screening Among Veterans
M. Rosario Ferreira, MD, MAPP, VA Chicago Lakeside Division Healthcare System, N Gorby, VA Chicago Lakeside Division Healthcare System, NC Dolan, Northwestern University, ML Fitzgibbon, Northwestern University, TC Davis, Louisiana State University, D Liu, Northwestern University, AW Rademaker, Northwestern University, CL Bennett, VA Chicago Lakeside Division Healthcare System

Objectives: To determine whether a combined patient/physician intervention increases colorectal cancer screening adherence, and whether it is effective for African-Americans and whites.

Methods: Randomized controlled intervention at outpatient firms, with one firm assigned to the intervention, the other to usual care. The patient component included an educational video and brochure. The physician component included quarterly sessions with feedback on screening recommendations and adherence. Subjects were males, 50 and older, who had not received screening. Main study outcomes were screening recommendations and adherence.

Results: There were 979 patients in the intervention firm and 941 patients in the usual care firm. Mean age was 67.8 years, 44% of patients were white and 50% were African-American, with no significant difference between the firms. At 6-12 months of follow-up 76% of patients in the intervention arm received screening recommendations, compared to 70% in the usual care arm (p=0.038); 41% of patients in the intervention arm completed screening, compared to 33% in the usual care arm (p=0.008). Recommendation rates were higher in the intervention arm compared to usual care arm for both African Americans (76% vs 71%) and whites (74% vs 68%). Adherence rates were also higher in the intervention firm for African-Americans (43% vs 37%) and whites (38% vs 29%).

Conclusions: Our combined patient/physician intervention significantly increased recommendations and adherence to colorectal cancer screening among Veterans, and had a similar effect among African-Americans and whites.

Impact: Interventions that increase adherence to colorectal cancer screening may improve veterans’ outcomes by reducing colorectal cancer-related mortality.