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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 45 Research Studies DisplayedCrawford J, Beaton D, Almad F
AHRQ Author: Bierman AS
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
The objective of this work was to develop a survey that considered cultural relevance and diversity of South Asian populations, with the aim of describing or predicting factors that influence colorectal cancer screening intention and adherence. The initial development of the Colon Cancer Screening Behaviours Survey for South Asian populations was completed using a number of steps. This initial survey was later cross-culturally translated and adapted into the Urdu language.
AHRQ-authored.
Citation: Crawford J, Beaton D, Almad F .
Cross-cultural survey development: the colon cancer screening behaviors survey for South Asian populations.
BMC Res Notes 2017 Dec 28;10(1):770. doi: 10.1186/s13104-017-3098-3.
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Keywords: Cancer, Cancer: Colorectal Cancer, Colonoscopy, Patient Adherence/Compliance, Racial and Ethnic Minorities, Screening
Kistler CE, Golin C, Morris C
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
This paper reports on the design of a randomized clinical trial to understand the effects of a patient decision aid on appropriate colorectal cancer screening. The study aims to determine the ability of a patient decision aid to increase individualized and appropriate colorectal cancer screening.
AHRQ-funded; HS021133.
Citation: Kistler CE, Golin C, Morris C .
Design of a randomized clinical trial of a colorectal cancer screening decision aid to promote appropriate screening in community-dwelling older adults.
Clin Trials 2017 Dec;14(6):648-58. doi: 10.1177/1740774517725289..
Keywords: Cancer, Cancer: Colorectal Cancer, Decision Making, Elderly, Prevention, Screening
Adams LB, Richmond J, Corbie-Smith G
Medical mistrust and colorectal cancer screening among African Americans.
The goal of this systematic review was to summarize evidence investigating associations between medical mistrust and CRC screening among African Americans, and variations in these associations by gender, CRC screening type, and level of mistrust. The study found that quantitative differences in mistrust and CRC screening by gender were mixed, but qualitative studies highlighted fear of experimentation and intrusiveness of screening methods as unique themes among African American men.
AHRQ-funded; HS000032.
Citation: Adams LB, Richmond J, Corbie-Smith G .
Medical mistrust and colorectal cancer screening among African Americans.
J Community Health 2017 Oct;42(5):1044-61. doi: 10.1007/s10900-017-0339-2..
Keywords: Cancer: Colorectal Cancer, Prevention, Racial and Ethnic Minorities, Screening
Singal AG, Gupta S, Skinner CS
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
Researchers compared the effectiveness of fecal immunochemical test (FIT) outreach and colonoscopy outreach to increase completion of the colorectal cancer (CRC) screening process (screening initiation and follow-up) within 3 years. Among persons aged 50 to 64 years receiving primary care at a safety-net institution, mailed outreach invitations offering FIT or colonoscopy compared with usual care increased the proportion completing CRC screening process within 3 years.
AHRQ-funded; HS022418.
Citation: Singal AG, Gupta S, Skinner CS .
Effect of colonoscopy outreach vs fecal immunochemical test outreach on colorectal cancer screening completion: a randomized clinical trial.
JAMA 2017 Sep 5;318(9):806-15. doi: 10.1001/jama.2017.11389.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Patient-Centered Outcomes Research
Pham R, Cross S, Fernandez B
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
This community-led study was conducted to assess patient preferences for fecal immunochemical tests (FIT) characteristics and to use study findings in concert with clinical effectiveness data to inform regional FIT selection. The authors concluded that FIT characteristics influenced patient's perceptions of test acceptability and feasibility and indicated that health system leaders, payers, and clinicians should select FITs that are both clinically effective and incorporate patient preferred test characteristics.
AHRQ-funded; HS022981.
Citation: Pham R, Cross S, Fernandez B .
"Finding the right FIT": rural patient preferences for fecal immunochemical test (FIT) characteristics.
J Am Board Fam Med 2017 Sep-Oct;30(5):632-44. doi: 10.3122/jabfm.2017.05.170151..
Keywords: Cancer: Colorectal Cancer, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Rural Health, Screening
Davis MM, Renfro S, Pham R
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
This study used Medicaid and commercial claims data to examine individual and geographic factors associated with colorectal cancer testing rates in Oregon. CRC testing in newly age-eligible Medicaid and commercial members remains markedly low. Disparities exist by gender, geographic residence, insurance coverage, and access to primary care.
AHRQ-funded; HS022981.
Citation: Davis MM, Renfro S, Pham R .
Geographic and population-level disparities in colorectal cancer testing: a multilevel analysis of Medicaid and commercial claims data.
Prev Med 2017 Aug;101:44-52. doi: 10.1016/j.ypmed.2017.05.001.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Disparities, Medicaid, Social Determinants of Health
Mehta HB, Vargas GM, Adhikari D
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
The objectives were to determine trends in the use of chemotherapy as the initial treatment and to evaluate the comparative effectiveness of initial chemotherapy vs resection of the primary tumor on survival (intention-to-treat analysis) in Stage IV colorectal cancer (CRC). Instrumental variable analysis found that, compared with resection, chemotherapy as the initial treatment offers similar or better 2-year survival in patients with Stage IV CRC.
AHRQ-funded; HS022134.
Citation: Mehta HB, Vargas GM, Adhikari D .
Comparative effectiveness of chemotherapy vs resection of the primary tumour as the initial treatment in older patients with Stage IV colorectal cancer.
Colorectal Dis 2017 Jun;19(6):O210-o18. doi: 10.1111/codi.13659.
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Keywords: Cancer: Colorectal Cancer, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Surgery
Garcia-Albeniz X, Hsu J, Hernan MA
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Researchers reviewed a recent observational analysis that explicitly emulated a target trial of screening colonoscopy using insurance claims from U.S. Medicare. They then compared this explicit emulation with alternative, simpler observational analyses. This empirical comparison suggests that lack of an explicit emulation of the target trial leads to biased estimates, and shows that allowing for repeated eligibility increases the statistical efficiency of the estimates.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Hernan MA .
The value of explicitly emulating a target trial when using real world evidence: an application to colorectal cancer screening.
Eur J Epidemiol 2017 Jun;32(6):495-500. doi: 10.1007/s10654-017-0287-2.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Comparative Effectiveness, Evidence-Based Practice, Research Methodologies
Ngo-Metzger Q, Rajupet S
AHRQ Author: Ngo-Metzger Q
Screening for colorectal cancer.
This case study involves a 50-year-old woman who presents for a routine visit. She is healthy with no significant medical history, takes no medications, and has no personal or family history of cancer. She asks about colorectal cancer screening. There are three multiple choice questions together with the U.S. Preventive Services Task Force answers, recommendations and related background information.
AHRQ-authored.
Citation: Ngo-Metzger Q, Rajupet S .
Screening for colorectal cancer.
Am Fam Physician 2017 May 15;95(10):653-54.
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Keywords: Cancer: Colorectal Cancer, Case Study, Colonoscopy, Prevention, Screening
Hoffman AS, Lowenstein LM, Kamath GR
An entertainment-education colorectal cancer screening decision aid for African American patients: a randomized controlled trial.
The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior. It found that viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy.
AHRQ-funded; HS022134.
Citation: Hoffman AS, Lowenstein LM, Kamath GR .
An entertainment-education colorectal cancer screening decision aid for African American patients: a randomized controlled trial.
Cancer 2017 Apr 15;123(8):1401-08. doi: 10.1002/cncr.30489.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Racial and Ethnic Minorities, Screening
Kanters A, Mullard AJ, Arambula J
Colorectal cancer: quality of surgical care in Michigan.
Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan with data from 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Adjusted process measures showed gaps in quality of care for CRC, suggesting opportunity for regional quality improvement.
AHRQ-funded; HS000053.
Citation: Kanters A, Mullard AJ, Arambula J .
Colorectal cancer: quality of surgical care in Michigan.
Am J Surg 2017 Mar;213(3):548-52. doi: 10.1016/j.amjsurg.2016.11.038.
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Keywords: Cancer: Colorectal Cancer, Quality of Care, Outcomes, Quality Measures, Surgery
Issaka RB, Singh MH, Oshima SM
Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system.
The effectiveness of stool-based colorectal cancer (CRC) screening is contingent on colonoscopy completion in patients with an abnormal fecal immunochemical test (FIT). This study found that FIT positive patients never referred to gastroenterology or who missed their appointment after referrals were more likely to have comorbid conditions and documented illicit substance use compared with patients who completed a colonoscopy.
AHRQ-funded; HS023558.
Citation: Issaka RB, Singh MH, Oshima SM .
Inadequate utilization of diagnostic colonoscopy following abnormal FIT results in an integrated safety-net system.
Am J Gastroenterol 2017 Feb;112(2):375-82. doi: 10.1038/ajg.2016.555.
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Keywords: Colonoscopy, Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality
Garcia-Albeniz X, Hsu J, Bretthauer M
Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study.
The researchers evaluated the effectiveness and safety of screening colonoscopy to prevent colorectal cancer (CRC) in persons aged 70 to 74 and those aged 75 to 79 years. They concluded that screening colonoscopy may have had a modest benefit in preventing CRC in beneficiaries aged 70 to 74 years and a smaller benefit in older beneficiaries.
AHRQ-funded; HS023128.
Citation: Garcia-Albeniz X, Hsu J, Bretthauer M .
Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study.
Ann Intern Med 2017 Jan 3;166(1):18-26. doi: 10.7326/m16-0758.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Elderly, Prevention, Screening
Martin J, Halm EA, Tiro JA
Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system.
This study aimed to characterize factors contributing to lack of follow-up colonoscopy in a racially diverse and socioeconomically disadvantaged cohort of patients with abnormal results on the fecal immunochemical test receiving care in an integrated safety-net health system. It concluded that lack of diagnostic evaluation is related to a combination of patient-, provider-, and system-level factors, highlighting the need for multilevel interventions to improve follow-up colonoscopy completion rates.
AHRQ-funded; HS022418.
Citation: Martin J, Halm EA, Tiro JA .
Reasons for lack of diagnostic colonoscopy after positive result on fecal immunochemical test in a safety-net health system.
Am J Med 2017 Jan;130(1):93.e1-93.e7. doi: 10.1016/j.amjmed.2016.07.028.
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Keywords: Colonoscopy, Cancer: Colorectal Cancer, Cancer, Diagnostic Safety and Quality
Martens CE, Crutchfield TM, Laping JL
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
The objectives for this paper were: (1) to improve understanding of preferences regarding potential colorectal cancer (CRC) screening program characteristics, and (2) to improve understanding of the barriers and facilitators around CRC screening with the Hispanic, immigrant community in North Carolina. They found that Hispanics may have a general awareness of and interest in CRC screening, but multiple barriers prevent them from getting screened, and recommended that special attention be given to designing culturally and linguistically appropriate programs to improve access to healthcare resources, insurance, and associated costs among Hispanics.
AHRQ-funded; HS019468.
Citation: Martens CE, Crutchfield TM, Laping JL .
Why wait until our community gets cancer?: Exploring CRC screening barriers and facilitators in the Spanish-speaking community in North Carolina.
J Cancer Educ 2016 Dec;31(4):652-59. doi: 10.1007/s13187-015-0890-4.
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Keywords: Cancer: Colorectal Cancer, Cultural Competence, Racial and Ethnic Minorities, Racial and Ethnic Minorities, Screening
Volk RJ, Linder SK, Lopez-Olivo MA
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
This systematic review describes studies evaluating patient decision aids for colorectal cancer screening in average-risk adults and their impact on knowledge, screening intentions, and uptake. It concluded that decision aids improve knowledge and interest in screening, and lead to increased screening over no information, but their impact on screening is similar to general colorectal cancer screening information.
AHRQ-funded; HS022134.
Citation: Volk RJ, Linder SK, Lopez-Olivo MA .
Patient decision aids for colorectal cancer screening: a systematic review and meta-analysis.
Am J Prev Med 2016 Nov;51(5):779-91. doi: 10.1016/j.amepre.2016.06.022.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Education: Patient and Caregiver, Healthcare Utilization, Screening
McNellis RJ, Beswick-Escanlar V
AHRQ Author: McNellis RJ
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
This case study involves a a 55-year-old man who presents to your office for a routine refill of his antihypertension medication, his 65-year-old brother who also visits you to ask about taking low-dose aspirin, and his 55-year-old wife, also your patient, who recently experienced abdominal pain,. It poses three multiple choice questions focused on the use of low-dose aspirin, together with the U.S. Preventive Services Task Force recommendations and related background information.
AHRQ-authored.
Citation: McNellis RJ, Beswick-Escanlar V .
Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer.
Am Fam Physician 2016 Oct 15;94(8):661-62.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Prevention, U.S. Preventive Services Task Force (USPSTF), Case Study
Halm EA, Beaber EF, McLerran D
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
The researchers assessed associations between primary care provider (PCP) visits and receipt of colorectal cancer (CRC) screening and colonoscopy after a positive fecal immunochemical (FIT) or fecal occult blood test (FOBT). They found that patients with a greater number of PCP visits had higher rates of both incident CRC screening and colonoscopy after positive FIT/FOBT, even in health systems with active population health outreach programs.
AHRQ-funded; HS022418.
Citation: Halm EA, Beaber EF, McLerran D .
Association between primary care visits and colorectal cancer screening outcomes in the era of population health outreach.
J Gen Intern Med 2016 Oct;31(10):1190-7. doi: 10.1007/s11606-016-3760-9..
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Patient-Centered Outcomes Research, Primary Care, Screening
Tyler Ellis C, Charlton ME, Stitzenberg KB
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
The researchers identified patient roles, preferences, and expectations as they relate to treatment decision making for patients with stage I rectal cancer. They found that, in this study of 154 adults with newly-diagnosed and surgically treated stage 1 rectal cancer, the preferred decision-making role for patients did not match the actual decision-making process. They recommended that future efforts focus on bridging the gap between the decision-making process and patient preferences regarding various treatment approaches.
AHRQ-funded; HS000032.
Citation: Tyler Ellis C, Charlton ME, Stitzenberg KB .
Patient-reported roles, preferences, and expectations regarding treatment of stage i rectal cancer in the cancer care outcomes research and surveillance consortium.
Dis Colon Rectum 2016 Oct;59(10):907-15. doi: 10.1097/dcr.0000000000000662.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Patient-Centered Outcomes Research, Patient Experience, Patient and Family Engagement
Healy MA, Grenda TR, Suwanabol PA
Colon cancer operations at high- and low-mortality hospitals.
The authors sought to evaluate causes of mortality following colon cancer operations across hospitals. They found significant variation in mortality across hospitals for colon cancer operations, reflecting a need for improved operative decision-making to enhance outcomes and quality of care.
AHRQ-funded; HS020937; HS023621; HS000053.
Citation: Healy MA, Grenda TR, Suwanabol PA .
Colon cancer operations at high- and low-mortality hospitals.
Surgery 2016 Aug;160(2):359-65. doi: 10.1016/j.surg.2016.04.035.
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Keywords: Adverse Events, Cancer: Colorectal Cancer, Mortality, Patient Safety, Surgery
Liss DT, Brown T, Lee JY
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Fecal occult blood testing (FOBT) is a pragmatic screening option for many community health centers (CHCs), but FOBT screening programs will not reduce mortality if patients with positive results do not undergo diagnostic colonoscopy (DC). This study was conducted to investigate DC completion among CHC patients. It found that DC completion was low overall, which raises concerns about whether FOBT can reduce CRC mortality in practice.
AHRQ-funded; HS021141.
Citation: Liss DT, Brown T, Lee JY .
Diagnostic colonoscopy following a positive fecal occult blood test in community health center patients.
Cancer Causes Control 2016 Jul;27(7):881-7. doi: 10.1007/s10552-016-0763-0.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Community-Based Practice, Screening
John-Baptiste A, Schapira MM, Cravens C
AHRQ Author: John-Baptiste A, Cravens C, Siegel J, Lawrence W
The role of decision models in health care policy: a case study.
In 2009, the Centers for Medicare and Medicaid Services (CMS) underwent a National Coverage Determination on computed tomography colonography (CTC) to screen for colorectal cancer. The Cancer Intervention & Surveillance Network developed decision models to inform this decision. The purpose of this study was to investigate the role of models in this decision. It concluded that decision makers involved in the CTC decision believed in the adequacy of models to inform coverage decisions.
AHRQ-authored.
Citation: John-Baptiste A, Schapira MM, Cravens C .
The role of decision models in health care policy: a case study.
Med Decis Making 2016 Jul;36(5):666-79. doi: 10.1177/0272989x16646732.
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Keywords: Cancer: Colorectal Cancer, Decision Making, Imaging, Policy
Chubak J, Whitlock EP, Williams SB
Aspirin for the prevention of cancer incidence and mortality: systematic evidence reviews for the U.S. Preventive Services Task Force.
The researchers conducted systematic reviews of aspirin and 1) total cancer mortality and incidence in persons eligible for primary prevention of cardiovascular disease (CVD) and 2) colorectal cancer (CRC) mortality and incidence in persons at average CRC risk.. Evidence from CVD primary and secondary prevention studies suggested that aspirin therapy reduces CRC incidence and perhaps mortality approximately 10 years after initiation.
AHRQ-funded; 290201200151I.
Citation: Chubak J, Whitlock EP, Williams SB .
Aspirin for the prevention of cancer incidence and mortality: systematic evidence reviews for the U.S. Preventive Services Task Force.
Ann Intern Med 2016 Jun 21;164(12):814-25. doi: 10.7326/m15-2117.
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Keywords: Cancer: Colorectal Cancer, Cardiovascular Conditions, Medication, Mortality, U.S. Preventive Services Task Force (USPSTF)
Rust G, Zhang S, Yu Z
Counties eliminating racial disparities in colorectal cancer mortality.
The researchers attempted to identify county-level variations in racial-ethnic disparities in colorectal cancer mortality rates. They found that county-level variation in social determinants, health care workforce, and health systems all were found to contribute to variations in cancer mortality disparity trend patterns from 1990 through 2010. They concluded that counties sustaining equality over time or moving from disparities to equality in cancer mortality suggest that disparities are not inevitable, and provide hope that more communities can achieve optimal and equitable cancer outcomes for all.
AHRQ-funded; HS022444.
Citation: Rust G, Zhang S, Yu Z .
Counties eliminating racial disparities in colorectal cancer mortality.
Cancer 2016 Jun 1;122(11):1735-48. doi: 10.1002/cncr.29958.
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Keywords: Cancer: Colorectal Cancer, Disparities, Mortality, Racial and Ethnic Minorities
Ellis CT, Samuel CA, Stitzenberg KB
National trends in nonoperative management of rectal adenocarcinoma.
The researchers examined the use of non-operative management (NOM) for rectal cancer over time and the patient- and facility-level factors associated with its use. They found evidence of increasing NOM use, with this increase occurring more frequently in black and uninsured/Medicaid patients, raising concern that increased NOM use may actually represent increasing disparities in rectal cancer care rather than innovation. They recommended further studies to assess survival differences by treatment strategy.
AHRQ-funded; HS000032.
Citation: Ellis CT, Samuel CA, Stitzenberg KB .
National trends in nonoperative management of rectal adenocarcinoma.
J Clin Oncol 2016 May 10;34(14):1644-51. doi: 10.1200/jco.2015.64.2066.
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Keywords: Cancer, Cancer: Colorectal Cancer, Disparities, Patient-Centered Healthcare, Treatments