Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct:109:106533.
doi: 10.1016/j.cct.2021.106533. Epub 2021 Aug 8.

Multilevel Follow-up of Cancer Screening (mFOCUS): Protocol for a multilevel intervention to improve the follow-up of abnormal cancer screening test results

Jennifer S Haas  1 , Steven J Atlas  2 , Adam Wright  3 , E John Orav  4 , David G Aman  5 , Erica S Breslau  6 , Timothy E Burdick  7 , Emily Carpenter  2 , Frank Chang  4 , Tin Dang  2 , Courtney J Diamond  2 , Sarah Feldman  8 , Kimberly A Harris  2 , Shoshana J Hort  9 , Molly L Housman  10 , Amrita Mecker  2 , Constance D Lehman  11 , Sanja Percac-Lima  2 , Rebecca Smith  10 , Amy J Wint  2 , Jie Yang  4 , Li Zhou  4 , Anna N A Tosteson  12
Affiliations

Multilevel Follow-up of Cancer Screening (mFOCUS): Protocol for a multilevel intervention to improve the follow-up of abnormal cancer screening test results

Jennifer S Haas et al. Contemp Clin Trials. 2021 Oct.

Abstract

Introduction: While substantial attention is focused on the delivery of routine preventive cancer screening, less attention has been paid to systematically ensuring that there is timely follow-up of abnormal screening test results. Barriers to completion of timely follow-up occur at the patient, provider, care team and system levels.

Methods: In this pragmatic cluster randomized controlled trial, primary care sites in three networks are randomized to one of four arms: (1) standard care, (2) "visit-based" reminders that appear in a patient's electronic health record (EHR) when it is accessed by either patient or providers (3) visit based reminders with population health outreach, and (4) visit based reminders, population health outreach, and patient navigation with systematic screening and referral to address social barriers to care. Eligible patients in participating practices are those overdue for follow-up of an abnormal results on breast, cervical, colorectal and lung cancer screening tests.

Results: The primary outcome is whether an individual receives follow-up, specific to the organ type and screening abnormality, within 120 days of becoming eligible for the trial. Secondary outcomes assess the effect of intervention components on the patient and provider experience of obtaining follow-up care and the delivery of the intervention components.

Conclusions: This trial will provide evidence for the role of a multilevel intervention on improving the follow-up of abnormal cancer screening test results. We will also specifically assess the relative impact of the components of the intervention, compared to standard care.

Trial registration: ClinicalTrials.gov NCT03979495.

Keywords: Cancer prevention; Cancer screening; Multilevel intervention.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Multilevel factors that influence the follow-up of an abnormal cancer screening test result.
Figure 2.
Figure 2.
Study Flow
See this image and copyright information in PMC

References

    1. Siu AL and the US Preventive Services Task Force. Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2016;164(4):279–296. - PubMed
    1. US Preventive Services Task Force, Curry SJ, Krist AH, et al. Screening for Cervical Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674–686. - PubMed
    1. American Cancer Society Guidelines for the Early Detection of Cancer. American Cancer Society. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidel.... Published 2020. Accessed.
    1. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(19):1965–1977. - PubMed
    1. US Preventive Services Task Force, Krist AH, Davidson KW, et al. Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;325(10):962–970. - PubMed

Publication types

Associated data