title: Factors in quality care--the case of follow-up to abnormal cancer screening tests--problems in the steps and interfaces of care.
abstract: To achieve the benefit of cancer screening, appropriate follow-up of abnormal screening test results must occur. Such follow-up requires traversing the transition between screening detection and diagnosis, including several steps and interfaces in care. This article reviews factors and interventions associated with follow-up of abnormal tests for cervical, breast and colorectal cancers. We synthesized 12 reviews of descriptive and intervention studies published between 1980 and 2008. There was wide variability in definition of follow-up, setting, study population, and reported prevalence rates. Correlates of follow-up included patient characteristics (eg, knowledge and age), social support, provider characteristics, practice (eg, having reminders systems), community and professional norms (eg, quality measures), and policy (eg, federal programs). Effective interventions included patient education and support; delivery systems design changes, such as navigation; and information system changes, most notably patient tracking and physician reminders. Few studies focused explicitly on interfaces and steps of care, such as communication between primary care and specialists, or simultaneously targeted the multilevel factors that affect care. Future practice and research priorities should include development of clear operational definitions of the steps and interfaces related to patients, providers, and organizations; reflect evolving guidelines and new technologies; determine priorities for intervention testing; and improve measures and apply appropriate study designs.
authors.affiliation: Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, 135 Cannon St, Charleston, SC 29425, USA. zapka@musc.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Zapka
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Taplin
authors.forename: Rebecca Anhang
authors.initials: RA
authors.lastname: Price
authors.forename: Caroline
authors.initials: C
authors.lastname: Cranos
authors.forename: Robin
authors.initials: R
authors.lastname: Yabroff
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D003266:Continuity of Patient Care / Q000458:organization & administration*; D057210:Delayed Diagnosis; D003695:Delivery of Health Care / Q000458:organization & administration; D055088:Early Detection of Cancer / Q000191:economics / Q000523:psychology; D016099:Endoscopy, Gastrointestinal / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006291:Health Policy; D006292:Health Priorities; D006801:Humans; D008297:Male; D008327:Mammography / Q000523:psychology / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration* / Q000523:psychology; D009780:Occult Blood; D010346:Patient Care Management / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation; D017010:Reminder Systems; D012944:Social Support; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data
references.citation: J Natl Cancer Inst Monogr. 2010;2010(40):38-57
references.pmid: 20386053
references.citation: Ann Intern Med. 2007 Apr 3;146(7):502-10
references.pmid: 17404352
references.citation: Br J Gen Pract. 1999 Mar;49(440):223-9
references.pmid: 10343430
references.citation: Am J Manag Care. 2008 May;14(5):277-82
references.pmid: 18471032
references.citation: J Am Board Fam Pract. 2001 Mar-Apr;14(2):123-30
references.pmid: 11314919
references.citation: Gastrointest Endosc. 2008 Jan;67(1):103-11
references.pmid: 18155431
references.citation: Med Care. 2008 Sep;46(9 Suppl 1):S74-83
references.pmid: 18725837
references.citation: Ann Intern Med. 2005 Jan 18;142(2):86-94
references.pmid: 15657156
references.citation: Gastrointest Endosc. 2007 Jul;66(1):108-12
references.pmid: 17591482
references.citation: Soc Sci Med. 2000 Mar;50(6):813-28
references.pmid: 10695979
references.citation: Cancer. 2004 Sep 1;101(5 Suppl):1251-9
references.pmid: 15316910
references.citation: Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1232-5
references.pmid: 16775188
references.citation: J Natl Cancer Inst Monogr. 2010;2010(40):90-6
references.pmid: 20386057
references.citation: Gastroenterology. 2008 May;134(5):1570-95
references.pmid: 18384785
references.citation: Cancer Epidemiol Biomarkers Prev. 2007 Nov;16(11):2293-303
references.pmid: 18006918
references.citation: Prev Med. 1998 Jan-Feb;27(1):13-31
references.pmid: 9465350
references.citation: Cancer. 2008 Oct 15;113(8):1999-2010
references.pmid: 18780320
references.citation: Curr Opin Oncol. 2002 Sep;14(5):505-11
references.pmid: 12192269
references.citation: Am J Prev Med. 2008 Jul;35(1 Suppl):S56-66
references.pmid: 18541188
references.citation: CA Cancer J Clin. 2008 May-Jun;58(3):161-79
references.pmid: 18443206
references.citation: J Fam Pract. 1996 Mar;42(3):303-5
references.pmid: 8636683
references.citation: Prev Med. 2000 Oct;31(4):429-39
references.pmid: 11006069
references.citation: Am J Gastroenterol. 2003 Sep;98(9):2078-81
references.pmid: 14499791
references.citation: Am J Prev Med. 2008 Jul;35(1 Suppl):S34-55
references.pmid: 18541187
references.citation: Cancer. 2004 Sep 1;101(5 Suppl):1165-87
references.pmid: 15329892
references.citation: Am J Gastroenterol. 2001 Jul;96(7):2086-92
references.pmid: 11467636
references.citation: Patient Educ Couns. 2008 Dec;73(3):473-9, 481
references.pmid: 18757164
references.citation: Med Care Res Rev. 2003 Sep;60(3):294-331
references.pmid: 12971231
references.citation: Med Care. 2002 Nov;40(11):1060-7
references.pmid: 12409851
references.citation: BMC Health Serv Res. 2008 Apr 25;8:91
references.pmid: 18439248
references.citation: J Gen Intern Med. 2007 Nov;22(11):1493-9
references.pmid: 17851721
references.citation: J Natl Cancer Inst. 2005 Mar 16;97(6):461
references.pmid: 15770012
references.citation: Public Health Rep. 2009 Sep-Oct;124(5):733-44
references.pmid: 19753952
references.citation: Am J Obstet Gynecol. 2007 Oct;197(4):346-55
references.pmid: 17904957
references.citation: Mayo Clin Proc. 2009 Apr;84(4):317-22
references.pmid: 19339648
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):2987-94
references.pmid: 18990740
references.citation: Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3279-83
references.pmid: 18990772
references.citation: Prev Med. 2007 Jan;44(1):26-33
references.pmid: 16962652
references.citation: J Natl Cancer Inst. 2005 May 4;97(9):675-83
references.pmid: 15870438
references.citation: J Natl Cancer Inst Monogr. 2010;2010(40):11-7
references.pmid: 20386049
references.citation: Hosp Q. 2003;7(1):73-82
references.pmid: 14674182
references.citation: J Womens Health (Larchmt). 2007 Apr;16(3):311-30
references.pmid: 17439377
references.citation: Obstet Gynecol. 2004 Feb;103(2):304-9
references.pmid: 14754700
references.citation: Eval Health Prof. 2006 Mar;29(1):126-53
references.pmid: 16510882
references.citation: JAMA. 2008 Jan 9;299(2):211-3
references.pmid: 18182604
references.citation: J Natl Cancer Inst. 1999 Oct 6;91(19):1641-6
references.pmid: 10511591
references.citation: Cancer Nurs. 2008 Sep-Oct;31(5):E16-30
references.pmid: 18772653
references.citation: J Obstet Gynecol Neonatal Nurs. 2001 Jan-Feb;30(1):80-8
references.pmid: 11277165
references.citation: Am J Prev Med. 2008 Jul;35(1 Suppl):S67-74
references.pmid: 18541190
references.citation: Soc Sci Med. 2009 Feb;68(3):479-86
references.pmid: 19081661
references.citation: J Womens Health (Larchmt). 2008 Jul-Aug;17(6):923-30
references.pmid: 18554094
references.citation: J Natl Cancer Inst Monogr. 2010;2010(40):3-10
references.pmid: 20386048
references.citation: Med Care Res Rev. 2007 Oct;64(5 Suppl):195S-242S
references.pmid: 17881627
references.citation: Milbank Q. 2001;79(2):281-315
references.pmid: 11439467
references.citation: Milbank Q. 2001;79(4):579-612, iv-v
references.pmid: 11789118
references.citation: Ann Fam Med. 2009 Jan-Feb;7(1):11-6
references.pmid: 19139444
references.citation: Cancer Causes Control. 2002 Apr;13(3):199-212
references.pmid: 12020101
references.citation: Aliment Pharmacol Ther. 2005 Dec;22(11-12):1069-77
references.pmid: 16305720
references.citation: Cancer. 2004 Sep 1;101(5 Suppl):1188-200
references.pmid: 15316914
references.citation: Med Care. 2008 Sep;46(9 Suppl 1):S62-7
references.pmid: 18725835
references.citation: Patient Educ Couns. 2004 Oct;55(1):32-9
references.pmid: 15476987
references.citation: Am J Gastroenterol. 2009 Oct;104(10):2543-54
references.pmid: 19550418
references.citation: Arch Fam Med. 1997 Nov-Dec;6(6):574-7
references.pmid: 9371052
references.citation: Soc Sci Med. 2008 Jan;66(2):260-75
references.pmid: 18022299
references.citation: BMC Public Health. 2008 Oct 16;8:358
references.pmid: 18925965
references.citation: Cancer Causes Control. 2006 Feb;17(1):29-38
references.pmid: 16411050
references.citation: Gastroenterology. 2003 Feb;124(2):544-60
references.pmid: 12557158
references.citation: CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66
references.pmid: 17237035
references.citation: J Gen Intern Med. 2003 May;18(5):357-63
references.pmid: 12795734
references.citation: Ann Intern Med. 2003 Aug 19;139(4):274-84
references.pmid: 12965983
references.citation: Arch Intern Med. 2009 Sep 28;169(17):1578-86
references.pmid: 19786677