title: Evaluation of the effect of an audit and feedback reporting tool on screening participation: The Primary Care Screening Activity Report (PCSAR).
abstract: Participation in cancer screening is critical to its effectiveness in reducing the burden of cancer. The Primary Care Screening Activity Report (PCSAR), an electronic report, was developed as an innovative audit and feedback tool to increase screening participation in Ontario's cancer screening programs. This study aims to assess its impact on patient screening participation. This study used a retrospective cohort design to evaluate the effectiveness of the 2014 PCSAR on screening participation in Ontario's three screening programs (breast, cervix and colorectal). The 3 cohorts comprised all participants eligible for each of the programs enrolled with a primary care physician in Ontario. Two exposures were evaluated for each cohort: enrollment with a physician who was registered to receive the PCSAR and enrollment with a registered physician who also logged into the PCSAR. Logistic regression modelling was used to assess the magnitude of the effect of PCSAR on participation, adjusting for participant and physician characteristics. Across all three screening programs, 63% of eligible physicians registered to receive the PCSAR and 38% of those registered logged-in to view it. Patients of physicians who registered were significantly more likely to participate in screening, with odds ratios ranging from 1.06 [1.04;1.09] to 1.15 [1.12;1.19]. The adjusted odds ratios associated with PCSAR log-in were 1.07 [1.03;1.12] to 1.18 [1.14;1.22] across all screening programs. Implementation of the PCSAR was associated with a small increase in screening participation. The PCSAR appears to be modestly effective in assisting primary care physicians in optimizing cancer screening participation among their patients.
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
authors.forename: Leigh
authors.initials: L
authors.lastname: Jonah
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Anna Kone
authors.initials: AK
authors.lastname: Pefoyo
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
authors.forename: Alex
authors.initials: A
authors.lastname: Lee
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
authors.forename: Joanne
authors.initials: J
authors.lastname: Hader
authors.affiliation: Provincial Primary Care Lead, Cancer Care Ontario, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Strasberg
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada; Division of Gynecologic Oncology, Sunnybrook Regional Cancer Centre, Toronto, ON, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kupets
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Chiarelli
authors.affiliation: Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada; Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, University of Toronto, Canada. Electronic address: jill.tinmouth@sunnybrook.ca.
authors.forename: Jill
authors.initials: J
authors.lastname: Tinmouth
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009864:Ontario; D058007:Physicians, Primary Care / Q000706:statistics & numerical data; D011320:Primary Health Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires / Q000706:statistics & numerical data*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis
keywords: Audit and feedback; Breast screening; Cervical screening; Colorectal screening; Organized cancer screening; Physician reporting; Screening participation