Results of a Randomized Controlled Trial to Increase Colorectal Cancer Screening in a Managed Care Health Plan

Published in: Cancer, v. 104, no. 10, Nov. 15, 2005, p. 2072-2083

Posted on RAND.org on January 01, 2005

by Patricia A. Ganz, Melissa M. Farmer, Michael J. Belman, Christine A. Garcia, Leanne Streja, Allen J. Dietrich, Charlotte Winchell, Roshan Bastani, Katherine L. Kahn

Read More

Access further information on this document at www3.interscience.wiley.com

This article was published outside of RAND. The full text of the article can be found at the link above.

BACKGROUND: Colorectal cancer (CRC) is the third most common cause of cancer deaths; however, rates of regular screening for this cancer are low. A quality improvement (QI) program to increase CRC screening was developed for use in a managed care health plan. METHODS: Thirty-six provider organizations (POs) contracting with the health plan were recruited for a randomized controlled effectiveness trial testing the QI program. The intervention was delivered over a 2-year period, and its effectiveness was assessed by chart review of a random sample of patients from each PO. RESULTS: Thirty-two of the 36 POs were evaluable for outcome assessment. During the 2-year intervention period, only 26% of the eligible patients received any CRC screening test. Twenty-nine percent of patients had any CRC screening test within guidelines, with no differences between the intervention or control POs. Significant predictors of having received CRC screening within guidelines were older age (P = 0.0004), receiving care in an integrated medical group (P < 0.0001) and having had a physical examination within the past 2 years (P < 0.0001). CONCLUSIONS: A facilitated QI intervention program for CRC screening that focused on the PO did not increase rates of CRC screening. Overall CRC screening rates are low and are in need of improvement.

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.