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Interventions to improve follow‐up of abnormal findings in cancer screening
Author(s) -
Bastani Roshan,
Yabroff K. Robin,
Myers Ronald E.,
Glenn Beth
Publication year - 2004
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20506
Subject(s) - psychological intervention , medicine , receipt , comparability , intervention (counseling) , health care , family medicine , intensive care medicine , nursing , computer science , mathematics , combinatorics , world wide web , economics , economic growth
The potential reduction in morbidity and mortality through cancer screening cannot be realized without receipt of appropriate follow‐up care for abnormalities identified via screening. In this paper, the authors critically examine the existing literature on correlates of receipt of appropriate follow‐up care for screen‐detected abnormalities, as well as the literature on interventions designed to increase rates of receipt of follow‐up care. Lessons learned describe what is known and not known about factors that are related to or predict receipt of follow‐up care. Similarly, effective interventions to increase follow‐up are described and gaps identified. A conceptual model is developed that categorizes the health care system in the United States as comprising four levels: policy, practice, provider, and patient. Some patient‐level factors that influence follow‐up receipt are identified, but the lack of data severely limit the understanding of provider, practice, and policy‐level correlates. The majority of intervention studies to increase follow‐up receipt have focused on patient‐level factors and have targeted follow‐up of abnormal Papanicolaou smears. Insufficient information is available regarding the effectiveness of provider, practice, or policy‐level interventions. Standard definitions of what constitutes appropriate follow‐up are lacking, which severely limit comparability of findings across studies. The validity of various methods of obtaining outcome data has not been clearly established. More research is needed on interventions targeting provider, system, and policy‐level factors, particularly interventions focusing on follow‐up of colorectal and breast abnormalities. Standardization of definitions and measures is needed to facilitate comparisons across studies. Cancer 2004. Published 2004 by the American Cancer Society.

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