Factors in quality care--the case of follow-up to abnormal cancer screening tests--problems in the steps and interfaces of care.
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.
Zapka
Jane
J
Department of Medicine, Division of Biostatistics and Epidemiology, Medical University of South Carolina, 135 Cannon St, Charleston, SC 29425, USA. zapka@musc.edu
Taplin
Stephen H
SH
Price
Rebecca Anhang
RA
Cranos
Caroline
C
Yabroff
Robin
R
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
J Natl Cancer Inst Monogr. 2010;2010(40):38-57
20386053
Ann Intern Med. 2007 Apr 3;146(7):502-10
17404352
Br J Gen Pract. 1999 Mar;49(440):223-9
10343430
Am J Manag Care. 2008 May;14(5):277-82
18471032
J Am Board Fam Pract. 2001 Mar-Apr;14(2):123-30
11314919
Gastrointest Endosc. 2008 Jan;67(1):103-11
18155431
Med Care. 2008 Sep;46(9 Suppl 1):S74-83
18725837
Ann Intern Med. 2005 Jan 18;142(2):86-94
15657156
Gastrointest Endosc. 2007 Jul;66(1):108-12
17591482
Soc Sci Med. 2000 Mar;50(6):813-28
10695979
Cancer. 2004 Sep 1;101(5 Suppl):1251-9
15316910
Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1232-5
16775188
J Natl Cancer Inst Monogr. 2010;2010(40):90-6
20386057
Gastroenterology. 2008 May;134(5):1570-95
18384785
Cancer Epidemiol Biomarkers Prev. 2007 Nov;16(11):2293-303
18006918
Prev Med. 1998 Jan-Feb;27(1):13-31
9465350
Cancer. 2008 Oct 15;113(8):1999-2010
18780320
Curr Opin Oncol. 2002 Sep;14(5):505-11
12192269
Am J Prev Med. 2008 Jul;35(1 Suppl):S56-66
18541188
CA Cancer J Clin. 2008 May-Jun;58(3):161-79
18443206
J Fam Pract. 1996 Mar;42(3):303-5
8636683
Prev Med. 2000 Oct;31(4):429-39
11006069
Am J Gastroenterol. 2003 Sep;98(9):2078-81
14499791
Am J Prev Med. 2008 Jul;35(1 Suppl):S34-55
18541187
Cancer. 2004 Sep 1;101(5 Suppl):1165-87
15329892
Am J Gastroenterol. 2001 Jul;96(7):2086-92
11467636
Patient Educ Couns. 2008 Dec;73(3):473-9, 481
18757164
Med Care Res Rev. 2003 Sep;60(3):294-331
12971231
Med Care. 2002 Nov;40(11):1060-7
12409851
BMC Health Serv Res. 2008 Apr 25;8:91
18439248
J Gen Intern Med. 2007 Nov;22(11):1493-9
17851721
J Natl Cancer Inst. 2005 Mar 16;97(6):461
15770012
Public Health Rep. 2009 Sep-Oct;124(5):733-44
19753952
Am J Obstet Gynecol. 2007 Oct;197(4):346-55
17904957
Mayo Clin Proc. 2009 Apr;84(4):317-22
19339648
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):2987-94
18990740
Cancer Epidemiol Biomarkers Prev. 2008 Nov;17(11):3279-83
18990772
Prev Med. 2007 Jan;44(1):26-33
16962652
J Natl Cancer Inst. 2005 May 4;97(9):675-83
15870438
J Natl Cancer Inst Monogr. 2010;2010(40):11-7
20386049
Hosp Q. 2003;7(1):73-82
14674182
J Womens Health (Larchmt). 2007 Apr;16(3):311-30
17439377
Obstet Gynecol. 2004 Feb;103(2):304-9
14754700
Eval Health Prof. 2006 Mar;29(1):126-53
16510882
JAMA. 2008 Jan 9;299(2):211-3
18182604
J Natl Cancer Inst. 1999 Oct 6;91(19):1641-6
10511591
Cancer Nurs. 2008 Sep-Oct;31(5):E16-30
18772653
J Obstet Gynecol Neonatal Nurs. 2001 Jan-Feb;30(1):80-8
11277165
Am J Prev Med. 2008 Jul;35(1 Suppl):S67-74
18541190
Soc Sci Med. 2009 Feb;68(3):479-86
19081661
J Womens Health (Larchmt). 2008 Jul-Aug;17(6):923-30
18554094
J Natl Cancer Inst Monogr. 2010;2010(40):3-10
20386048
Med Care Res Rev. 2007 Oct;64(5 Suppl):195S-242S
17881627
Milbank Q. 2001;79(2):281-315
11439467
Milbank Q. 2001;79(4):579-612, iv-v
11789118
Ann Fam Med. 2009 Jan-Feb;7(1):11-6
19139444
Cancer Causes Control. 2002 Apr;13(3):199-212
12020101
Aliment Pharmacol Ther. 2005 Dec;22(11-12):1069-77
16305720
Cancer. 2004 Sep 1;101(5 Suppl):1188-200
15316914
Med Care. 2008 Sep;46(9 Suppl 1):S62-7
18725835
Patient Educ Couns. 2004 Oct;55(1):32-9
15476987
Am J Gastroenterol. 2009 Oct;104(10):2543-54
19550418
Arch Fam Med. 1997 Nov-Dec;6(6):574-7
9371052
Soc Sci Med. 2008 Jan;66(2):260-75
18022299
BMC Public Health. 2008 Oct 16;8:358
18925965
Cancer Causes Control. 2006 Feb;17(1):29-38
16411050
Gastroenterology. 2003 Feb;124(2):544-60
12557158
CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66
17237035
J Gen Intern Med. 2003 May;18(5):357-63
12795734
Ann Intern Med. 2003 Aug 19;139(4):274-84
12965983
Arch Intern Med. 2009 Sep 28;169(17):1578-86
19786677