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. 2013 Oct 29:13:449.
doi: 10.1186/1472-6963-13-449.

Effectiveness of an organized colorectal cancer screening program on increasing adherence in asymptomatic average-risk Canadians

Thomas J Charters  1 , Erin C Strumpf, Maida J Sewitch
Affiliations

Effectiveness of an organized colorectal cancer screening program on increasing adherence in asymptomatic average-risk Canadians

Thomas J Charters et al. BMC Health Serv Res. .

Abstract

Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer and second highest cause of cancer-related mortality in Canada. Despite the availability of screening services and establishment of guidelines, utilization of colorectal cancer screening in Canada remains low. In 2008, the province of Ontario launched ColonCancerCheck, an organized colorectal cancer screening program aimed at increasing CRC screening adherence. In this study, we adopt a quasi-experimental approach to estimate and describe the impact of ColonCancerCheck on screening behavior in the asymptomatic average risk population.

Methods: Annual screening rates from the target population were estimated using five cycles of the Canadian Community Health Survey, a cross-sectional nationally representative survey of health status, healthcare use, and determinants of health in the Canadian population. We used a difference-in-differences design to measure the overall impact of ColonCancerCheck on past-year fecal occult blood testing (FOBT) and endoscopy in Ontario relative to the rest of Canada. Several verification tests validated the suitability of our model specification.

Results: The difference-in-differences analysis shows that ColonCancerCheck increased FOBT screening in the average risk population by 5.2 percentage points (95% CI [3.2, 7.2]), an increase of 33% relative to pre-program screening rates. The program had no observed effect on endoscopy screening and we found no evidence that ColonCancerCheck differentially altered the screening practices of population sub-groups.

Conclusions: Our findings suggest ColonCancerCheck has been successful at increasing use of FOBT in the asymptomatic average risk population.

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Figures

Figure 1
Figure 1
Past Year CRC Screening in Canada.
See this image and copyright information in PMC

References

    1. Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Statistics 2013. Toronto: Canadian Cancer Society; 2013.
    1. Cancer Care Ontario. Insight on Cancer: News and Information on Colorectal Cancer and Screening in Ontario, vol. 7. Toronto: Canadian Cancer Society (Ontario Division); 2008.
    1. Cancer Care Manitoba. Cancer in Manitoba Incidence and Mortality 2007 Annual Statistical Report. Winnipeg: Manitoba Epidemiology and Cancer Registry; 2010.
    1. Ries LAG, Wingo PA, Miller DS, Howe HL, Weir HK, Rosenberg HM, Vernon SW, Cronin K, Edwards BK. The annual report to the nation on the status of cancer, 1973–1997, with a special section on colorectal cancer. Cancer. 2000;88(10):2398–2424. doi: 10.1002/(SICI)1097-0142(20000515)88:10<2398::AID-CNCR26>3.0.CO;2-I. - DOI - PubMed
    1. Maroun J, Ng E, Berthelot JM, Le Petit C, Dahrouge S, Flanagan WM, Walker H, Evans WK. Lifetime costs of colon and rectal cancer management in Canada. Chronic Dis Can. 2003;24(4):91–101. - PubMed

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