title: Long-term results from a randomized controlled trial to increase cancer screening among attendees of community health centers.
abstract: OBJECTIVE
  We assessed whether increased cancer screening rates that were observed with Cancer Screening Office Systems (Cancer SOS) could be maintained at 24 months' follow-up, a period in which clinics were expected to be largely self-sufficient in maintaining the intervention.
  
  
  METHODS
  Eight primary care clinics serving disadvantaged populations in Hills-borough County, Fla, agreed to take part in a cluster-randomized experimental trial. Charts of independent samples of established patients aged 50 to 75 years were abstracted, with data collected at baseline (n = 1,196) and at 24 months' follow-up (n = 1,296). Papanicolaou (Pap) smears, mammography, and fecal occult blood testing were assessed.
  
  
  RESULTS
  At 24 months of follow-up, intervention patients had received a greater number of cancer screening tests (mean 1.17 tests vs 0.94 tests, t test = 4.42, P <.0001). In multivariate analysis that controlled for baseline screening rates, secular trends, and other patient and clinic characteristics, the intervention increased the odds of mammograms slightly (odds ratio [OR]) = 1.26; 95% confidence interval [CI], 1.02-1.55; P = .03) but had no effect on fecal occult blood tests (OR = 1.17; 95% CI, 0.92-1.48; P =0.19) or Pap smears (OR = 0.88; 95% CI, 0.0.68-1.15; P = .34).
  
  
  CONCLUSIONS
  The Cancer SOS intervention had persistent, although modest, effects on screening at 24 months' follow-up, an effect that had clearly diminished from results reported at 12 months' follow-up. Further study is needed to develop successful intervention strategies that are either self-sustaining or that are able to produce long-term changes in screening behavior.
authors.affiliation: Department of Family Medicine, University of South Florida., Tampa 33612, USA. rroetzhe@hsc.usf.edu
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Christman
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schroeder
authors.forename: Rania
authors.initials: R
authors.lastname: Abdulla
authors.forename: Seft
authors.initials: S
authors.lastname: Hunter
mesh_terms: D000368:Aged; D003151:Community Health Centers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors