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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 107 Research Studies Displayed
Hicklin K, O'Leary MC, Nambiar S
Assessing the impact of multicomponent interventions on colorectal cancer screening through simulation: what would it take to reach national screening targets in North Carolina?
The authors simulated the impact of multicomponent interventions in North Carolina over 5 years to assess the potential for meeting national screening targets for colorectal cancer (CRC). They reported that each multicomponent intervention was associated with increased CRC screening and averted both CRC cases and deaths, while three had the potential to reach screening targets.
AHRQ-funded; HS022981.
Citation:
Hicklin K, O'Leary MC, Nambiar S .
Assessing the impact of multicomponent interventions on colorectal cancer screening through simulation: what would it take to reach national screening targets in North Carolina?
Prev Med 2022 Sep;162:107126. doi: 10.1016/j.ypmed.2022.107126..
Keywords:
Cancer: Colorectal Cancer, Cancer, Screening, Colonoscopy, Prevention
Sanchez JI, Shankaran V, Unger JM
Disparities in post-operative surveillance testing for metastatic recurrence among colorectal cancer survivors.
This population-based study assesses individual- and neighborhood-level factors associated with receipt of carcinoembryonic antigen (CEA) and computer tomography (CT) surveillance testing. Using SEER-Medicare data to identify beneficiaries diagnosed with colorectal cancer (CRC) stages II-III, they found that, overall, 78% and 58% of CRC survivors received CEA and CT testing, respectively. Further, Medicare-Medicaid dual coverage was associated with 39% lower odds of receipt of CEA tests among non-Hispanic Whites, while Blacks with dual coverage had almost two times the odds of receiving CEA tests compared to Blacks without dual coverage. Although this study did not find significant differences in receipt of initial CEA and CT surveillance testing across racial/ethnic groups, the assessment of the factors that measure access to care suggests differences in access to these procedures within racial/ethnic groups.
AHRQ-funded; HS013853.
Citation:
Sanchez JI, Shankaran V, Unger JM .
Disparities in post-operative surveillance testing for metastatic recurrence among colorectal cancer survivors.
J Cancer Surviv 2022 Jun;16(3):638-49. doi: 10.1007/s11764-021-01057-z..
Keywords:
Disparities, Cancer: Colorectal Cancer, Cancer
Guirguis-Blake JM, Evans CV, Perdue LA
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence summary reviewed the benefits and harms of aspirin in primary cardiovascular disease (CVD) and colorectal cancer (CRC) prevention to accompany the final recommendation and evidence review of the US Preventive Services Task Force. A literature review was conducted of English-language randomized clinical trials (RCTs) of low-dose aspirin compared with placebo or no intervention in primary prevention populations. Aspirin was found not to be significantly associated with reductions in CVD mortality or all-cause mortality. There was limited trial evidence on benefits for CRC, with the findings highly variable by length of follow-up and statistically significant only when considering long-term observational follow-up beyond randomized trial periods. Low-dose aspirin was associated with significant increases in total major bleeding and in site-specific bleeding.
AHRQ-funded; 290201500007I.
Citation:
Guirguis-Blake JM, Evans CV, Perdue LA .
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Apr 26;327(16):1585-97. doi: 10.1001/jama.2022.3337..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Dehmer SP, O'Keefe LR, Evans CV
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
The purpose of the study was to develop, model, and report estimates of the harms from and benefits of the use of low-dose aspirin for the prevention of cardiovascular disease (CVD) and colorectal cancer (CRC.) The researchers developed and used a simulation model to provide estimates for hypothetical United States cohorts of men and women between the ages of forty and seventy-nine years without a previous history of elevated bleeding risks or CVD, and up to a 20% 10-year risk for a CVD event. The model focused on the routine, lifetime use of low-dose aspirin with 5-year intervals of no use between 65 and 85 years of age. The study’s primary outcome was lifetime net benefit which was measured in life-years and quality-adjusted life-years (QALYs.) Harms included an increase in nonfatal intracranial hemorrhage and gastrointestinal bleeding, and benefits included a reduction in nonfatal ischemic stroke and myocardial infarction. The study found that the estimated lifetime net quality-adjusted life-years was positive for men and women with 5% or more 10-year CVD risk when they started use between the ages of 40-59 years, and for men and women with 10% or greater 10-year CVD risk when starting between the ages of 60 and 69 years. The estimated lifetime net life-years were mostly negative for those starting low-dose aspirin use between 60 and 79 years of age. Five-year intervals of stopping use between 65 and 85 years of age did not provide a significant advantage to lifetime use. The researchers concluded that the routine, lifetime use of low-dose aspirin may benefit several population groups, with the largest estimated benefit in those with greater 10-year CVD risk who begin routine, low-dose aspirin dosage at younger ages.
AHRQ-funded; 290201500007I.
Citation:
Dehmer SP, O'Keefe LR, Evans CV .
Aspirin use to prevent cardiovascular disease and colorectal cancer: updated modeling study for the US Preventive Services Task Force.
JAMA 2022 Apr 26;327(16):1598-607. doi: 10.1001/jama.2022.3385..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Prevention, Cardiovascular Conditions, Cancer: Colorectal Cancer, Cancer, Prevention, Evidence-Based Practice
Brajcich BC, Benson AB, Gantt G
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758.
AHRQ-funded; HS026385.
Citation:
Brajcich BC, Benson AB, Gantt G .
Management of colorectal cancer during the COVID-19 pandemic: recommendations from a statewide multidisciplinary cancer collaborative.
J Surg Oncol 2022 Mar;125(4):560-63. doi: 10.1002/jso.26758..
Keywords:
COVID-19, Cancer: Colorectal Cancer, Cancer, Guidelines, Evidence-Based Practice, Healthcare Delivery
Mojica CM, Gunn R, Pham R
An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees.
This study was conducted to describe clinical workflows for fecal immunochemical tests/fecal occult blood tests (FIT/FOBT) in Oregon primary care practices and to identify specific workflow processes that might be associated with higher colorectal cancer (CRC) screening rates. Findings showed that primary care practices with higher CRC screening rates among newly age-eligible Medicaid enrollees had more established visit-based and population outreach workflows to support identifying patients due for screening, FIT/FOBT distribution, reminders, and follow up. Higher CRC screening was associated with having medical assistants discuss and review FIT/FOBT screening and instructions with patients.
AHRQ-funded; HS022981.
Citation:
Mojica CM, Gunn R, Pham R .
An observational study of workflows to support fecal testing for colorectal cancer screening in primary care practices serving Medicaid enrollees.
BMC Cancer 2022 Jan 25;22(1):106. doi: 10.1186/s12885-021-09106-7..
Keywords:
Workflow, Screening, Cancer: Colorectal Cancer, Cancer, Primary Care, Vulnerable Populations
Fan T, Stefanos R
Screening for colorectal cancer.
This AHRQ-authored Putting Preventions in Practice quiz has three questions and answers on the US Preventive Services Task Force final recommendation on screening for colorectal cancer. A case study is presented with questions on the best behavioral interventions, the effect of a patient’s age on the counseling approach, and what is an appropriate test and interval for colorectal screening. References are also provided at the end of the answers.
AHRQ-authored.
Citation:
Fan T, Stefanos R .
Screening for colorectal cancer.
Am Fam Physician 2021 Sep 1;104(3):295-96..
Keywords:
U.S. Preventive Services Task Force (USPSTF), Cancer: Colorectal Cancer, Cancer, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Archambault AN, Lin Y, Jeon J
Nongenetic determinants of risk for early-onset colorectal cancer.
This study compared whether risk factors associated with late-onset colorectal cancer (CRC) were also linked to early-onset CRC which is defined as onset younger than 50 years of age. Data was pooled from 13 population-based studies using 3767 CRC cases and 4040 controls aged younger than 50 years and 23,437 CRC cases and 35,311 controls aged 50 years and older. Early-onset CRC was not associated with any of the risk factors for late-onset CRC (regular nonsteroidal anti-inflammatory drug use, greater red meat intake, lower educational attainment, alcohol abstinence, and heavier alcohol use). The authors also evaluated risks by anatomic subsite and found that lower total fiber intake was linked more strongly to rectal than colon cancer.
AHRQ-funded; HS026120.
Citation:
Archambault AN, Lin Y, Jeon J .
Nongenetic determinants of risk for early-onset colorectal cancer.
JNCI Cancer Spectr 2021 Jun;5(3):pkab029. doi: 10.1093/jncics/pkab029..
Keywords:
Cancer: Colorectal Cancer, Cancer, Risk
Glenn BA, Nonzee NJ, Hamilton AS
Cancer surveillance and preventive services in a diverse sample of breast and colorectal cancer survivors.
This study assessed engagement in surveillance for recurrence, cancer screening, and other recommended preventive health services among breast and colorectal cancer survivors with early-onset disease (age 50 years and younger) who were diagnosed in California. Findings showed that, although the majority of survivors received appropriate surveillance for recurrence, engagement in other preventive health services varied substantially. Implications included efforts to address gaps in the use of recommended cancer screening and preventive health services among cancer survivors.
AHRQ-funded; HS000046.
Citation:
Glenn BA, Nonzee NJ, Hamilton AS .
Cancer surveillance and preventive services in a diverse sample of breast and colorectal cancer survivors.
J Cancer Surviv 2021 Apr;15(2):213-23. doi: 10.1007/s11764-020-00925-4..
Keywords:
Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer, Prevention, Screening
Sanchez JI, Shankaran V, Unger JM
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
After colorectal cancer (CRC) surgery, surveillance with colonoscopy is an important step for the early detection of local recurrence. Unfortunately, surveillance colonoscopy is underused, especially among racial/ethnic minorities. This study assessed the association between patient and neighborhood factors and receipt of surveillance colonoscopy. The investigators concluded that receipt of initial surveillance colonoscopy remained low, and that there were acute disparities between Black and NHW patients.
AHRQ-funded; HS013853.
Citation:
Sanchez JI, Shankaran V, Unger JM .
Inequitable access to surveillance colonoscopy among Medicare beneficiaries with surgically resected colorectal cancer.
Cancer 2021 Feb;127(3):412-21. doi: 10.1002/cncr.33262..
Keywords:
Colonoscopy, Cancer: Colorectal Cancer, Cancer, Access to Care, Screening, Prevention, Disparities, Medicare
Vu JV, Sheetz KH, De Roo AC
Variation in colectomy rates for benign polyp and colorectal cancer.
Removal of pre-cancerous polyps on screening colonoscopy is a mainstay of colorectal cancer (CRC) prevention. Complex polyps may require surgical removal with colectomy, an operation with a 17% morbidity and 1.5% mortality rate. Recently, advanced endoscopic techniques have allowed some patients with complex polyps to avoid the morbidity of colectomy. In this study, the investigators compared regional variation in colectomy rates for CRC versus benign polyp.
AHRQ-funded; HS000053.
Citation:
Vu JV, Sheetz KH, De Roo AC .
Variation in colectomy rates for benign polyp and colorectal cancer.
Surg Endosc 2021 Feb;35(2):802-08. doi: 10.1007/s00464-020-07451-5..
Keywords:
Cancer: Colorectal Cancer, Cancer, Surgery, Colonoscopy
Shah SC, Itzkowitz SH
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
One of the most feared complications of inflammatory bowel disease [IBD]-associated colitis is colorectal cancer. An opportunity for early detection is being missed in a group that is overlooked as high-risk, as a substantial proportion of colorectal cancers are being diagnosed in individuals with colonic IBD who have disease duration shorter than when guidelines recommend surveillance initiation. In this study, the investigators discuss a viewpoint that supports a paradigm shift that will ideally result in a more effective and higher-value colorectal cancer prevention approach in IBD.
AHRQ-funded; HS026395.
Citation:
Shah SC, Itzkowitz SH .
Reappraising risk factors for inflammatory bowel disease-associated neoplasia: implications for colonoscopic surveillance in IBD.
J Crohns Colitis 2020 Sep 7;14(8):1172-77. doi: 10.1093/ecco-jcc/jjaa040..
Keywords:
Digestive Disease and Health, Risk, Cancer: Colorectal Cancer, Cancer, Colonoscopy, Prevention, Diagnostic Safety and Quality, Screening
Radhakrishnan A, Reyes-Gastelum D, Gay B
Primary care provider involvement in thyroid cancer survivorship care.
While prior research has examined how primary care providers (PCPs) can care for breast and colon cancer survivors, little is known about their role in thyroid cancer survivorship. The purpose of this study was to understand PCP involvement and confidence in thyroid cancer survivorship care. The investigators found that while PCPs reported being involved in long-term surveillance, gaps remained in their confidence in handling survivorship care. They indicated that thyroid cancer survivorship guidelines that delineate PCP roles present one opportunity to increase confidence about their participation.
AHRQ-funded; HS024512.
Citation:
Radhakrishnan A, Reyes-Gastelum D, Gay B .
Primary care provider involvement in thyroid cancer survivorship care.
J Clin Endocrinol Metab 2020 Sep;105(9):e3300-6. doi: 10.1210/clinem/dgaa437..
Keywords:
Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer, Primary Care
Nelson HD, Cantor A, Wagner J
Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis.
This study evaluated the effectiveness of patient navigation to increase screening for colorectal, breast, and cervical cancer in populations adversely affected by health care disparities. Two of the investigators independently abstracted study data and assessed study quality and applicability using criteria adapted from the USPSTF. Findings indicated that, in populations adversely affected by disparities, colorectal, breast, and cervical cancer screening rates were higher in patients provided navigation services.
AHRQ-funded; 290201500009I.
Citation:
Nelson HD, Cantor A, Wagner J .
Effectiveness of patient navigation to increase cancer screening in populations adversely affected by health disparities: a meta-analysis.
J Gen Intern Med 2020 Jul 22;35(10):3026-35. doi: 10.1007/s11606-020-06020-9..
Keywords:
Cancer, Disparities, Cancer: Colorectal Cancer, Screening, Prevention, Women, Health Promotion
Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD
Completeness of operative reports for rectal cancer surgery.
This study examined the completeness of operative reports for rectal cancer surgery and whether they contain the key elements recommended by the National Accreditation Program for Rectal Cancer. Ten hospitals in Michigan submitted rectal cancer operative reports from June-December 2018. These reports were analyzed for completeness and to identify key elements in the synoptic operative template. Out of 110 reports, 31 contained all 24 elements and they all used a synoptic template. Overall, 62 reported used a synoptic template and 48 did not.
AHRQ-funded; HS000053.
Citation:
Kanters AE, Vu JV, Schuman AD AE, Vu JV, Schuman AD .
Completeness of operative reports for rectal cancer surgery.
Am J Surg 2020 Jul;220(1):165-69. doi: 10.1016/j.amjsurg.2019.09.036..
Keywords:
Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
Mahmoud R, Shah SC, Torres J
Association between indefinite dysplasia and advanced neoplasia in patients with inflammatory bowel diseases undergoing surveillance.
Little is known about the clinical significance of indefinite dysplasia (IND) in patients with inflammatory bowel diseases (IBD) undergoing colonoscopic surveillance for colorectal neoplasia. The investigators conducted a retrospective cohort analysis from 2001 through 2017. They concluded that patients with IBD undergoing colorectal neoplasia surveillance with consistent histopathologic grading of dysplasia, IND was independently associated with a significant increase in risk of advanced colorectal neoplasia.
AHRQ-funded; HS026395.
Citation:
Mahmoud R, Shah SC, Torres J .
Association between indefinite dysplasia and advanced neoplasia in patients with inflammatory bowel diseases undergoing surveillance.
Clin Gastroenterol Hepatol 2020 Jun;18(7):1518-27.e3. doi: 10.1016/j.cgh.2019.08.032..
Keywords:
Cancer: Colorectal Cancer, Cancer, Digestive Disease and Health
De Roo AC, Morris AM, Vu JV
Characteristics of patients seeking second opinions at a multidisciplinary colorectal cancer clinic.
The purpose of this study was to describe the patient and treatment characteristics of patients seeking initial and second opinions in colorectal cancer care at a multidisciplinary colorectal cancer clinic. Findings showed that patients seeking a second opinion represent a unique subset of patients with colorectal cancer. In general, they are younger and more likely to have stage IV or recurrent disease than patients seeking an initial opinion. Although transfer of care to a multidisciplinary colorectal cancer clinic after second opinion is lower than for initial consultations, multidisciplinary colorectal cancer clinics provide an important role for patients with complex disease characteristics and treatment needs.
AHRQ-funded; HS000053.https://www.pubmed.ncbi.nlm.nih.gov/32109918
Citation:
De Roo AC, Morris AM, Vu JV .
Characteristics of patients seeking second opinions at a multidisciplinary colorectal cancer clinic.
Dis Colon Rectum 2020 Jun;63(6):788-95. doi: 10.1097/dcr.0000000000001647..
Keywords:
Cancer: Colorectal Cancer, Cancer, Transitions of Care
Davis SN, Wischhusen JW, Sutton SK
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
This study examined the frequency of limited health literacy and demographic and psychosocial factors associated with limited health literacy in a sample of older black Americans. The participants enrolled in a community-based intervention to promote colorectal cancer screening and completed baseline surveys that assessed their health literacy using the Rapid Estimate of Adult Literacy in Medicine, Revised (REALM-R) test, CRC awareness, cancer fatalism, Preventive Health Model (PHM) constructs, and demographics. Findings showed that limited health literacy was associated with multiple complex factors. Recommendations include interventions to incorporate patient health literacy and low-literacy materials that can be delivered through multiple channels.
AHRQ-funded; HS026120.
Citation:
Davis SN, Wischhusen JW, Sutton SK .
Demographic and psychosocial factors associated with limited health literacy in a community-based sample of older Black Americans.
Patient Educ Couns 2020 Feb;103(2):385-91. doi: 10.1016/j.pec.2019.08.026..
Keywords:
Health Literacy, Racial / Ethnic Minorities, Elderly, Screening, Cancer: Colorectal Cancer, Cancer, Prevention
Takvorian SU, Oganisian A, Mamtani R
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
The effect of the Patient Protection and Affordable Care Act's Medicaid expansion on cancer care delivery and outcomes is unknown. Patients with cancer are a high-risk group for whom treatment delays are particularly detrimental. The objective of this study was to examine the association between Medicaid expansion and changes in insurance status, stage at diagnosis, and timely treatment among patients with incident breast, colon, and non-small cell lung cancer.
AHRQ-funded; HS026116.
Citation:
Takvorian SU, Oganisian A, Mamtani R .
Association of Medicaid expansion under the Affordable Care Act with insurance status, cancer stage, and timely treatment among patients with breast, colon, and lung cancer.
JAMA Netw Open 2020 Feb 5;3(2):e1921653. doi: 10.1001/jamanetworkopen.2019.21653.
.
.
Keywords:
Cancer: Breast Cancer, Cancer: Colorectal Cancer, Cancer: Lung Cancer, Cancer, Health Insurance, Medicaid, Policy, Health Services Research (HSR)
Murphy CC, Sen A, Watson B
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
This systematic review examined the prevalence of repeat fecal occult blood tests (FOBT) for colorectal cancer screening. MEDLINE, Embase, and the Cochrane Library were searched for studies published from 1997 to 2017 and reported repeat FOBT over 2 and more screening rounds. Thirty-five articles (n=27) were identified which measured repeat FOBT as 1) proportion of Round 1 participants completing repeat FOBT in Round 2; 2) proportion completing two, consecutive FOBTs; or 3) proportion completing 3 or more rounds. The number of participants completing Round 1 ranged from 24.6% to 89.6%. Those who completed Round 2 ranged from 16.4% to 80%; and completion of 3 or more rounds ranged from 0.8% to 64.1%. Repeat FOBT was higher in mailed outreach than opportunistic screening.
AHRQ-funded; HS022418.
Citation:
Murphy CC, Sen A, Watson B .
A systematic review of repeat fecal occult blood tests for colorectal cancer screening.
Cancer Epidemiol Biomarkers Prev 2020 Feb;29(2):278-87. doi: 10.1158/1055-9965.Epi-19-0775..
Keywords:
Cancer: Colorectal Cancer, Cancer, Screening, Diagnostic Safety and Quality, Prevention, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Evidence-Based Practice
De Roo AC, Li Y, Abrahamse PH
Long-term functional decline after high-risk elective colorectal surgery in older adults.
This study examined the long-term risks of functional decline after elective colorectal surgery in older adults. This retrospective matched cohort study used data from the Health and Retirement Study, a nationally representative, longitudinal survey of adults >50 years of age. This survey collected data on functional status, cognition, and demographics, among other topics. The survey was linked with Medicare claims and National Death Index data from 1992 to 2012 and used patients 65 years and older. Surgery patients did experience a greater likelihood of functional decline with or without complications compared to control subjects. The older the patient, the more likelihood of a functional decline occurring after surgery.
AHRQ-funded; HS000053.
Citation:
De Roo AC, Li Y, Abrahamse PH .
Long-term functional decline after high-risk elective colorectal surgery in older adults.
Dis Colon Rectum 2020 Jan;63(1):75-83. doi: 10.1097/dcr.0000000000001541..
Keywords:
Elderly, Cancer: Colorectal Cancer, Cancer, Surgery, Adverse Events, Risk
Schlick CJR, Liu JY, Yang AD
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
Venous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. The objectives of this study were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.
AHRQ-funded; HS024516; HS026385.
Citation:
Schlick CJR, Liu JY, Yang AD .
Pre-operative, intra-operative, and post-operative factors associated with post-discharge venous thromboembolism following colorectal cancer resection.
J Gastrointest Surg 2020 Jan;24(1):144-54. doi: 10.1007/s11605-019-04354-2..
Keywords:
Cancer: Colorectal Cancer, Cancer, Surgery, Blood Clots, Adverse Events, Risk, Hospital Discharge
Kanters AE, Cleary RK, Obi SH
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Investigators sought to assess trends in total mesorectal excision performance and grading in Michigan hospitals. They found that the rates of total mesorectal excision performance and grade assignment were widely variable throughout the state of Michigan. Overall, grade assignment remained very low, suggesting an opportunity for quality improvement projects to increase total mesorectal excision performance and grading, involving both the surgeons and pathologists for effective implementation.
AHRQ-funded; HS000053.
Citation:
Kanters AE, Cleary RK, Obi SH .
Uptake of total mesorectal excision and total mesorectal excision grading for rectal cancer: a statewide study.
Dis Colon Rectum 2020 Jan;63(1):53-59. doi: 10.1097/dcr.0000000000001526..
Keywords:
Cancer: Colorectal Cancer, Cancer, Surgery, Quality Improvement, Quality of Care
Hassmiller Lich K, O'Leary MC, Nambiar S
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Researchers used microsimulation to estimate the health and financial effects of insurance expansion and reduction scenarios in North Carolina (NC) for colorectal cancer screening (CRC). The full lifetime of a simulated population of residents age-eligible for CRC screening (aged 50-75) during a 5-year period were simulated. Findings indicate that the estimated cost savings--balancing increased CRC screening/testing costs against decreased cancer treatment costs--were approximately $30 M and $970 M for Medicaid expansion and Medicare-for-all scenarios, respectively, compared to status quo. The researchers concluded that insurance expansion will likely improve CRC screening both overall and in underserved populations while saving money, with the largest savings realized by Medicare.
AHRQ-funded; HS022981.
Citation:
Hassmiller Lich K, O'Leary MC, Nambiar S .
Estimating the impact of insurance expansion on colorectal cancer and related costs in North Carolina: a population-level simulation analysis.
Prev Med 2019 Dec;129s:105847. doi: 10.1016/j.ypmed.2019.105847..
Keywords:
Health Insurance, Cancer: Colorectal Cancer, Cancer, Healthcare Costs, Screening, Prevention, Medicaid, Medicare, Policy, Access to Care
Symer MM, Sedrakyan A, Yeo HL
Case sequence analysis of the robotic colorectal resection learning curve.
This study examined trends in the increasing rate of resection surgery for colorectal cancer using robots. It has a major learning curve so investigators wanted to see if complication rates went down as the technology become more common. The cohort included adults undergoing colorectal section from 2008 through 2016 from data in the New York Statewide Planning and Research Cooperative database. The number of procedures started at 76 cases in 2010 and increased to 702 cases in 2015. Findings were that major complications (myocardial infarction, pulmonary embolism, shock, and death) did not decrease but iatrogenic complications were reduced. The odds of prolonged length of stay also decreased over time.
AHRQ-funded; HS000066.
Citation:
Symer MM, Sedrakyan A, Yeo HL .
Case sequence analysis of the robotic colorectal resection learning curve.
Dis Colon Rectum 2019 Sep;62(9):1071-78. doi: 10.1097/dcr.0000000000001437..
Keywords:
Cancer: Colorectal Cancer, Cancer, Surgery, Education: Continuing Medical Education, Outcomes
