Cancer Screening in an Urban Population

In public health, screening tests are essential in the prevention and early detection of diseases. The following journal article outlines a study conducted on the usefulness of colorectal cancer screening. Randi L. Wolf, Basch, C. , Brouse, C, Shmukler, C. and Shea, S. (2006). Patient Preferences and Adherence to Colorectal Cancer Screening in an Urban Population. American Journal ofPublic Health 96 (5). Design of the Study The research study implemented the randomized trial.

It was done by evaluating tailored telephone intervention versus standard print communications for increasing CRC screening. Rationale This study addressed the issue why screening rates remained low in the United States amidst recommendation for CRC screening. The research was an intervention study based on the data collected as part of the Healthy Colon Project. It was the first to examine the relation between CRC screening preferences and verified screening outcomes.

It aimed to measure patient preferences for colorectal cancer (CRC) screening strategies and actual receipt of alternative CRC screening tests among an urban minority sample. Methodology The study was based on data collected as part of the Healthy Colon Project, a randomized trial evaluating tailored telephone intervention versus standard print communications for increasing CRC screening. Participants were members of a large health care workers union (or beneficiaries) in the New York City metropolitan area that did not have a recent CRC screening test on the basis of self-report.

The sample for this analysis included the 226 participants assigned to receive telephone education. (http://www. ajph. org/cgi/content/full/96/5/809#SEC1) Procedure Outline: Conclusion: The result showed that fecal occult blood test was the most preferred test, reportedly owing to its convenience and the noninvasive nature. For individuals who obtained a test that was other than their stated preference, reasons for the discordance may be due to physician preferences that override patient preferences.

The result further showed no association between test preference and demographic subgroups, except for income level, and all tests were fully covered by the participants’ insurance. Medicare to cover the cost of all CRC screening tests is significant. Limitations of the study with regards to its applicability to the general population: It is not generalized to other populations, especially those with no health insurance. Who pays for the test is deemed crucial.

Examining the details of this research study propose an alternative research study design that would address the same research goals of this study and explain how the alternative study design would answer the research questions. A cross-sectional survey was already done on attitudes toward colorectal cancer screening tests for patients and physicians by Ling BS et al 2001. A randomized controlled trial should also be done on nature or content of the interpersonal communication between the patient and the physician at the time the CRC screening test was ordered.

Nature and content of the interpersonal communication between the patient and the physician play an important role on the patient preferences for colorectal cancer (CRC) screening strategies and actual receipt of alternative CRC screening tests. Such alternative research study design would further validate the issue on preferences and actualization, on plan and outcome.

BIBLIOGRAPHY

Wolf et. al. (2006). PatientPreferences and Adherence to Colorectal Cancer Screening in an Urban Population. American Journal of Public Health 96 (5); 809.

Retrieved May 27, 2008 Ling BS, Moskowitz MA, Wachs D, Pearson B, Schroy PC (2005). Attitudes Toward Colorectal Cancer Screening Tests – A Survey of Patients and Physicians. Journal of General Internal Medicine. 16 (12), 822-830. http://www. ajph. org/cgi/content/full/96/5/809#SEC1 http://www. medicare. gov/health/awareness. asp. http://cel. isiknowledge. com/InboundService. do? product=CEL&action=retrieve&SrcApp=Hi ghwire&UT=000172835700005&SID=1B8klCFdM5KcFdlelOF&Init=Yes&SrcAuth=Highwire&mode=FullRecord&customersID=Highwire

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