Colorectal Cancer Screening Project | 2023-13_Quality Metrics for Abnormal Colorectal Cancer Screening Test Follow Up and Strategies for Implementation

13_Quality Metrics for Abnormal Colorectal Cancer Screening Test Follow Up and Strategies for Implementation

Pdf Summary

This document highlights the importance of quality metrics for follow-up on abnormal colorectal cancer (CRC) tests and provides strategies for implementing these metrics. The rationale behind the need for these metrics includes increased risk and mortality associated with late-stage CRC, disparities in non-invasive test utilization among at-risk populations, and wasted resources. The changing landscape of CRC screening, with the emergence of more sensitive stool-based and blood-based tests, is also discussed.<br /><br />The proposed quality metrics include the proportion of patients with abnormal non-invasive tests who complete colonoscopy and a modified CRC metric that counts only "complete" CRC screening and follow-up. The goal for both proposed metrics is set at 80%. The document weighs the trade-offs between the two metrics, highlighting the pros and cons of each.<br /><br />The implementation strategies for these metrics involve establishing feasibility through examples from Kaiser and various health center systems. It emphasizes the need for personnel such as care coordinators/navigators, tracking mechanisms like registries or spreadsheets, and standardized workflows and toolkits. The importance of primary clinician engagement, patient health, and addressing liability concerns is also emphasized.<br /><br />In summary, the document argues that an abnormal CRC screening test follow-up quality metric is crucial for improving public health, reducing liability, and optimizing the role of gastroenterologists in CRC screening. The best metric proposed is the proportion of people with abnormal tests who complete colonoscopy. The document concludes by highlighting the feasibility of measuring these metrics and the potential impact they can have on improving screening and follow-up rates.

Asset Subtitle

Samir Gupta, MD, MSCS, AGAF

Keywords

quality metrics

abnormal colorectal cancer tests

follow-up

CRC screening

non-invasive tests

disparities

sensitive stool-based tests

blood-based tests

proportion of patients

complete colonoscopy