NIH Colorectal Cancer Screening Conference - Panel Statement

full=text ► (large)NIH Colorectal Cancer Screening Conference - Panel Statement: "NIH State-of-the-Science Conference:
Enhancing Use and Quality of Colorectal Cancer Screening

February 2–4, 2010
Bethesda, Maryland

Final Panel Statement

For Printing and Download: [PDF Version]► http://consensus.nih.gov/2010/docs/CRC%20SOS%202010%20Final%20Panel%20Statement.pdf

NIH consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of (1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ), (2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session, (3) questions and statements from conference attendees during open discussion periods that are part of the public session, and (4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.


The statement reflects the panel’s assessment of medical knowledge available at the time the statement was written. Thus, it provides a “snapshot in time” of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.



Contents

Abstract

Introduction

1. What are the recent trends in the use and quality of colorectal cancer screening?
2. What factors influence the use of colorectal cancer screening?
3. Which strategies are effective in increasing the appropriate use of colorectal cancer screening and follow-up?
4. What are the current and projected capacities to deliver colorectal cancer screening and surveillance at the population level?
5. What are the effective approaches for monitoring the use and quality of colorectal cancer screening?
6. What research is needed to make the most progress and have the greatest public health impact in promoting the appropriate use of colorectal cancer screening?

Conclusions

Panel

Speakers

Planning Committee

Sponsors

Additional Information





Abstract


Objective: To provide health care providers, patients, and the general public with a responsible assessment of currently available data on enhancing use and quality of colorectal cancer screening.


Participants: A non-DHHS, nonadvocate 13-member panel representing the fields of cancer surveillance, health services research, community-based research, informed decision-making, access to care, health care policy, health communication, health economics, health disparities, epidemiology, statistics, thoracic radiology, internal medicine, gastroenterology, public health, end-of-life care, and a public representative. In addition, 20 experts from pertinent fields presented data to the panel and conference audience.


Evidence: Presentations by experts and a systematic review of the literature prepared by the RTI International–University of North Carolina Evidence-based Practice Center, through the Agency for Healthcare Research and Quality. Scientific evidence was given precedence over anecdotal experience.


Conference Process: The panel drafted its statement based on scientific evidence presented in open forum and on published scientific literature. The draft statement was presented on the final day of the conference and circulated to the audience for comment. The panel released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government.



Conclusions: The panel finds that despite substantial progress toward higher colorectal cancer screening rates nationally, screening rates fall short of desirable levels. Targeted initiatives to improve screening rates and reduce disparities in underscreened communities and population subgroups could further reduce colorectal cancer morbidity and mortality. This could be achieved by utilizing the full range of screening options and evidence-based interventions for increasing screening rates. With additional investments in quality monitoring, Americans could be assured that all screening achieves high rates of cancer prevention and early detection. To close the gap in screening, this report identifies the following priority areas for implementation and research to enhance the use and quality of colorectal cancer screening:



* Eliminate financial barriers to colorectal cancer screening and appropriate follow up.
* Widely implement interventions that have proven effective at increasing colorectal cancer screening, including patient reminder systems and one-on-one interactions with providers, educators, or navigators.
* Conduct research to assess the effectiveness of tailoring programs to match the characteristics and preferences of target population groups to increase colorectal cancer screening.
* Implement systems to ensure appropriate follow-up of positive colorectal cancer screening results.
* Develop systems to assure high quality of colorectal cancer screening programs.
* Conduct studies to determine the comparative effectiveness of the various colorectal cancer screening methods in usual practice settings.

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