Colorectal Cancer: Improving Screening Compliance with the Utilization of FIT-DNA (Cologuard)
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Abstract
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States (U.S.), but with the appropriate screening processes, this staggering fact can change (CDC, 2018). Routine CRC screening is one of the most powerful defenses in the fight against CRC, yet screening remains substantially underutilized (American Cancer Society, 2017). The United States Preventative Services Task Force (USPSTF) recommends screening those at average risk starting at age 50 and continuing to age 75 (USPSTF, 2016). Despite current recommendations, it is estimated that only 58.9% of qualifying women and 56.7% of qualifying men in the U.S. have been screened for CRC (Cooper & Gelb, 2016). One proposed mechanism to improve CRC screening compliance is to offer patients screening options, keeping in mind that the best screening is the one that gets done (USPSTF, 2016). Fecal-immunochemical test-deoxyribonucleic acid (FIT-DNA) is a recently approved stool-based test that offers an additional screening choice for patients. The addition of FIT-DNA has the potential to increase CRC screening rates and providing education regarding current USPSTF recommendations could improve screening uptake. The purpose of this quality improvement project was to implement and evaluate educational deliverables distributed to healthcare workers and patients within a local health system, and to analyze the influence of these deliverables on CRC screening rates and FIT-DNA utilization. Electronic memos were delivered to providers and staff regarding up-to-date screening recommendations. In effort to promote autonomy and informed decision-making, an electronic, printable educational tool was developed and distributed to patients at average risk for CRC. Data were collected on CRC screening rates and FIT-DNA utilization pre- and posteducation implementation to evaluate if a positive trend existed. Although there were statistical and evaluative limitations of the project, findings showed that the distribution of educational tools trended with an increase in CRC screening rates and FIT-DNA utilization. Based on results of the evaluation, education to providers, staff, and patients on current screening recommendations, and offering patients more screening options, can improve CRC screening compliance.