title: Variation in colorectal cancer screening steps in primary care: basis for practice improvement.
abstract: No published research has assessed the specific steps that primary care practices actually take to carry out screening for colorectal cancer (CRC). A written survey was distributed to clinicians and staff at 15 primary care practices to determine whether they perceived that personnel in their practices performed a series of 4 steps associated with screening colonoscopy and 7 steps associated with stool blood test screening. For each discrete step, the percentage of respondents from each practice who indicated that a given step is performed in that practice was calculated along with the mean of practice percentages. Survey results indicate wide variation in the degree to which these screening steps are performed across the 15 practices.  Variation was greater for steps that involved contacting nonresponders (reminders), scheduling, and rescheduling. Survey responses suggest substantial variation and much room for improvement in practice performance of evidence-based steps in the CRC screening process.
authors.affiliation: Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA. Mona.sarfaty@jefferson.edu
authors.forename: Mona
authors.initials: M
authors.lastname: Sarfaty
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Harris
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Borsky
authors.forename: Randa
authors.initials: R
authors.lastname: Sifri
authors.forename: James
authors.initials: J
authors.lastname: Cocroft
authors.forename: Brian
authors.initials: B
authors.lastname: Stello
authors.forename: Melanie
authors.initials: M
authors.lastname: Johnson
mesh_terms: D003113:Colonoscopy / Q000592:standards / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D009780:Occult Blood; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data*; D058996:Quality Improvement; D011795:Surveys and Questionnaires