National Healthcare Quality and Disparities Report
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Topics
- Access to Care (1)
- Cancer (6)
- Cancer: Breast Cancer (1)
- Cancer: Cervical Cancer (1)
- (-) Cancer: Colorectal Cancer (24)
- Cancer: Prostate Cancer (3)
- Case Study (1)
- Colonoscopy (9)
- Comparative Effectiveness (4)
- Decision Making (2)
- Diagnostic Safety and Quality (3)
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- Elderly (3)
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- Outcomes (1)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (5)
- Patient Adherence/Compliance (1)
- Prevention (4)
- Quality Measures (1)
- Quality of Care (2)
- Racial and Ethnic Minorities (3)
- Research Methodologies (1)
- Rural Health (2)
- Screening (12)
- Social Determinants of Health (3)
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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 24 of 24 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
Elstad EA, Sheridan SL, Lee JG
Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes.
The researchers aimed to determine whether newspapers portrayed screening for prostate and colorectal cancers differently after the 2008 USPSTF recommendation changes. In US newspapers from 2005 to 2012, they found that benefits in prostate cancer screening articles and harms and benefits in colonoscopy articles did not change over time, but mentions of prostate cancer screening harms increased after 2008. They concluded that consumers, especially lay consumers, are receiving unbalanced information on cancer screening.
AHRQ-funded; HS021133; HS000032.
Citation: Elstad EA, Sheridan SL, Lee JG .
Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes.
J Behav Med 2014 Dec;37(6):1242-51. doi: 10.1007/s10865-014-9572-7.
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Keywords: Cancer: Colorectal Cancer, Colonoscopy, Cancer: Prostate Cancer, Screening, U.S. Preventive Services Task Force (USPSTF)
Abdelsattar ZM, Wong SL, Birkmeyer NJ
Multi-institutional assessment of sphincter preservation for rectal cancer.
This study sought to identify whether variation in sphincter preservation surgery (SPS) rates for patients with rectal cancer can be explained by patient, tumor, or treatment-related factors across hospitals. It found that SPS rates vary by hospital, even after accounting for clinical characteristics using detailed chart review.
AHRQ-funded; HS000053
Citation: Abdelsattar ZM, Wong SL, Birkmeyer NJ .
Multi-institutional assessment of sphincter preservation for rectal cancer.
Ann Surg Oncol. 2014 Dec;21(13):4075-80. doi: 10.1245/s10434-014-3882-4..
Keywords: Cancer: Colorectal Cancer, Quality of Care, Surgery
Pignone MP, Crutchfield TM, Brown PM
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
This study used a discrete choice experiment (DCE) to learn about how vulnerable individuals in North Carolina value different aspects of CRC screening programs. It found that follow-up cost coverage was most frequently found to be the most important attribute from the DCE (47 percent); followed by test reward/copayment (33 percent).
AHRQ-funded; HS019468.
Citation: Pignone MP, Crutchfield TM, Brown PM .
Using a discrete choice experiment to inform the design of programs to promote colon cancer screening for vulnerable populations in North Carolina.
BMC Health Serv Res 2014 Nov 30;14:611. doi: 10.1186/s12913-014-0611-4..
Keywords: Cancer: Colorectal Cancer, Health Promotion, Rural Health, Screening, Social Determinants of Health
Rabin BA, Ellis JL, Steiner JF
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
The authors described health service utilization patterns of subgroups of prostate cancer and colorectal cancer (CRC) patients with different relative probabilities of dying of their cancer or other conditions. They found that although a new diagnosis of cancer increased utilization of cancer-related services for an extended time period, the timing of cancer diagnosis did not appear to affect other types of utilization.
AHRQ-funded; HS019520.
Citation: Rabin BA, Ellis JL, Steiner JF .
Health-care utilization by prognosis profile in a managed care setting: using the Surveillance, Epidemiology and End Results Cancer Survival Calculator SEER*CSC.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):275-81. doi: 10.1093/jncimonographs/lgu023.
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Keywords: Cancer: Prostate Cancer, Cancer: Colorectal Cancer, Cancer, Healthcare Utilization, Mortality, Healthcare Delivery
Thompson CA, Gomez SL, Chan A
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
The researchers performed multivariable modeling to evaluate potential predictors (at the provider- and patient-level) of screening completion among Asian patients. They concluded that language- and gender-concordant primary care providers and culturally tailored online health resources may help improve preventive cancer screening in Asian patient populations.
AHRQ-funded; HS019815.
Citation: Thompson CA, Gomez SL, Chan A .
Patient and provider characteristics associated with colorectal, breast, and cervical cancer screening among Asian Americans.
Cancer Epidemiol Biomarkers Prev 2014 Nov;23(11):2208-17. doi: 10.1158/1055-9965.epi-14-0487..
Keywords: Cancer: Breast Cancer, Cancer: Cervical Cancer, Cancer: Colorectal Cancer, Healthcare Utilization, Screening
Feuer EJ, Rabin BA, Zou Z
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
The researchers externally validate the nomograms for prostate and colorectal cancer using data from Kaiser Permanente Colorado. Their results indicated that the colorectal and prostate cancer nomograms are reliable tools for physicians and patients to use to obtain information on prognosis and assist in establishing priorities for both treatment of the cancer and other conditions, particularly when a patient is elderly and/or has significant comorbidities.
AHRQ-funded; HS019520.
Citation: Feuer EJ, Rabin BA, Zou Z .
The Surveillance, Epidemiology, and End Results Cancer Survival Calculator SEER*CSC: validation in a managed care setting.
J Natl Cancer Inst Monogr 2014 Nov;2014(49):265-74. doi: 10.1093/jncimonographs/lgu021.
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Keywords: Cancer: Colorectal Cancer, Cancer: Prostate Cancer, Cancer, Mortality
Lairson DR, Parikh RC, Cormier JN
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
The authors investigated community-level evidence on the effectiveness and cost effectiveness of treatment for stage III colon cancer for elderly patients among those receiving no chemotherapy, 5-fluorouracil (5-FU), and FOLFOX (5-FU + oxaliplatin). They concluded that FOLFOX appears more effective and cost effective than other strategies for colon cancer treatment of older patients, with results being sensitive to age.
AHRQ-funded; HS018956.
Citation: Lairson DR, Parikh RC, Cormier JN .
Cost-utility analysis of chemotherapy regimens in elderly patients with stage III colon cancer.
Pharmacoeconomics 2014 Oct;32(10):1005-13. doi: 10.1007/s40273-014-0180-8.
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Keywords: Cancer: Colorectal Cancer, Comparative Effectiveness, Healthcare Costs, Elderly, Patient-Centered Outcomes Research
Zhang Y, Fu SS, Du XL
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
The authors examined the temporal trend and predictors of receiving hematopoietic growth factors in a large nationwide and population-based cohort of patients with colorectal cancer in the USA from 1992 to 2009. They found that gender, marital status, comorbidity scores, geographic area, year of diagnosis, tumor stage, number of lymph nodes, and risk profile for febrile neutropenia were statistically significant predictors of using colony-stimulating factors and erythropoiesis-stimulating agents.
AHRQ-funded; HS018956.
Citation: Zhang Y, Fu SS, Du XL .
Increasing utilization and predictors of hematopoietic growth factors in patients diagnosed with colorectal cancer: findings from a large national population-based cohort in the USA, 1992-2009.
Med Oncol 2014 Oct;31(10):242. doi: 10.1007/s12032-014-0242-y.
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Keywords: Cancer: Colorectal Cancer, Healthcare Utilization, Medication, Patient-Centered Outcomes Research
Wheeler SB, Kuo TM, Goyal RK
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
The researchers examined colorectal cancer (CRC) testing across regions of North Carolina by using population-based Medicare and Medicaid claims data from disabled individuals who turned 50 years of age during 2003-2008. They found that fewer than 50% of eligible individuals had evidence of CRC testing; men, African-Americans, Medicaid beneficiaries, and those living furthest away from endoscopy facilities had significantly lower odds of CRC testing, with significant regional variation.
AHRQ-funded; HS019468.
Citation: Wheeler SB, Kuo TM, Goyal RK .
Regional variation in colorectal cancer testing and geographic availability of care in a publicly insured population.
Health Place 2014 Sep;29:114-23. doi: 10.1016/j.healthplace.2014.07.001.
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Keywords: Access to Care, Cancer: Colorectal Cancer, Disparities, Screening, Social Determinants of Health
Pruitt SL, Leonard T, Zhang S
Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
The researchers described variability in colorectal cancer (CRC) test use across multiple levels, including physician, clinic, and neighborhood; and (ii) compared the performance of novel cross-classified models versus traditional hierarchical models. Significant variability was observed across all levels in both hierarchical and cross-classified models that was unexplained by measured covariates. For colonoscopy, variance was similar across all levels.
AHRQ-funded; HS022418.
Citation: Pruitt SL, Leonard T, Zhang S .
Physicians, clinics, and neighborhoods: multiple levels of influence on colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2014 Jul;23(7):1346-55. doi: 10.1158/1055-9965.epi-13-1130..
Keywords: Cancer: Colorectal Cancer, Diagnostic Safety and Quality, Screening